Individual
KATHRYN W HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1111 NE 99TH AVE STE 200, PORTLAND, OR 97220-9442
(503) 963-3030
Mailing address
847 NE 19TH AVE STE 300, PORTLAND, OR 97232-2686
(503) 963-2801
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD209507
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500750910
—
OR
Enumeration date
06/09/2016
Last updated
09/07/2022
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