Provider Demographics
NPI:1003065160
Name:BENCHOFF, MICHAEL ANN (MSW)
Entity Type:Individual
Prefix:
First Name:MICHAEL ANN
Middle Name:
Last Name:BENCHOFF
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 N. GANTENBEIN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1418
Mailing Address - Country:US
Mailing Address - Phone:503-803-1784
Mailing Address - Fax:
Practice Address - Street 1:421 SW OAK STREET
Practice Address - Street 2:SUITE 520
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204
Practice Address - Country:US
Practice Address - Phone:503-988-4949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor