Provider Demographics
NPI:1871311878
Name:PORSEVA, KHRYSTYNA
Entity type:Individual
Prefix:
First Name:KHRYSTYNA
Middle Name:
Last Name:PORSEVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 SW OAK ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-3936
Mailing Address - Country:US
Mailing Address - Phone:503-577-5845
Mailing Address - Fax:503-713-5576
Practice Address - Street 1:428 SW OAK ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-3936
Practice Address - Country:US
Practice Address - Phone:503-577-5845
Practice Address - Fax:503-713-5576
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor