Individual
DR. KRISTEN S WELLENBROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
13908 SE STARK ST, PORTLAND, OR 97233-2161
(503) 255-2343
(503) 255-2344
Mailing address
PO BOX 16308, PORTLAND, OR 97292-0308
(503) 255-2343
(503) 255-2344
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2665
OR
Other
Enumeration date
04/28/2016
Last updated
06/07/2022
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