Individual
KEITH JACOB HENDRIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
45 NW GREELEY AVE, BEND, OR 97703-2943
(503) 616-1236
(855) 305-5252
Mailing address
53501 BROOKIE WAY, LA PINE, OR 97739-9440
(503) 616-1236
(855) 305-5252
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C1799
OR
101YP2500X
Professional Counselor
Primary
C1799
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123190
—
OR
Enumeration date
03/06/2008
Last updated
11/10/2020
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