Provider Demographics
NPI:1356226864
Name:KJ WASHAM COUNSELING LLC
Entity type:Organization
Organization Name:KJ WASHAM COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:WASHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT, CADC III
Authorized Official - Phone:503-421-5358
Mailing Address - Street 1:4800 MEADOWS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-5277
Mailing Address - Country:US
Mailing Address - Phone:503-421-5358
Mailing Address - Fax:503-421-5358
Practice Address - Street 1:4800 MEADOWS RD
Practice Address - Street 2:SUITE 300
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035
Practice Address - Country:US
Practice Address - Phone:503-421-5358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health