Provider Demographics
NPI:1699497768
Name:KRITZ, CLAUDIA ELLEN (PHD)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:ELLEN
Last Name:KRITZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3318 SW FAIRMOUNT BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-1476
Mailing Address - Country:US
Mailing Address - Phone:503-260-5029
Mailing Address - Fax:
Practice Address - Street 1:3318 SW FAIRMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-1476
Practice Address - Country:US
Practice Address - Phone:503-260-5029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1289103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical