Doctor Name: | KONRAD A VON WALTHER |
NPI Number: | 1356606537 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW |
License Number: | |
Business Practice Address: | 38872 Proctor Blvd Sandy, OR - 970558035 |
Business Phone Number: | 5037226950 |
Business Fax Number: | 5037226939 |
Mailing Address: | 2051 Kaen Rd, Suite 367 OREGON CITY |
State: | OR |
Postal Code: | 970454035 |
Phone Number: | 5037425300 |
Fax Number: | 5037425979 |
NPI Enumeration Date: | 07/12/2012 |
NPI Last Update Date: | 05/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |