Individual
MICHELA KENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
672 NW AUTUMNCREEK WAY APT M303, BEAVERTON, OR 97006-7789
(314) 304-7484
Mailing address
1704 SE 170TH AVE, VANCOUVER, WA 98683-3445
(314) 304-7484
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
139664
IA
152W00000X
Optometrist
Primary
3446ATI
OR
152W00000X
Optometrist
4078
MN
152W00000X
Optometrist
60280003
WA
152W00000X
Optometrist
OD.OD.60280003
WA
152W00000X
Optometrist
OPT-002978
AZ
Other
Enumeration date
06/18/2012
Last updated
08/13/2026
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