Individual
KATHLEEN M HENNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6160 SW ARCTIC DR, BEAVERTON, OR 97005-9448
(503) 646-7777
Mailing address
PO BOX 66500, PORTLAND, OR 97290-6500
(503) 657-8663
(503) 723-3180
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
146154
OR
Other
Enumeration date
12/11/2009
Last updated
12/11/2009
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