Individual
DR. MICHELLE HENNINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3800 N INTERSTATE AVE, PORTLAND, OR 97227-1110
(503) 330-5139
Mailing address
3800 N INTERSTATE AVE, PORTLAND, OR 97227-1110
(503) 330-5139
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1452
OR
103TC0700X
Clinical Psychologist
Primary
1452
OR
Other
Enumeration date
04/26/2007
Last updated
05/31/2025
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