Provider Demographics
NPI:1003894858
Name:HALLENBURG, KRIS S (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:S
Last Name:HALLENBURG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KRIS
Other - Middle Name:H
Other - Last Name:POASA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:66 CLUB RD
Mailing Address - Street 2:STE 120
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2439
Mailing Address - Country:US
Mailing Address - Phone:541-393-5983
Mailing Address - Fax:541-393-5984
Practice Address - Street 1:66 CLUB RD
Practice Address - Street 2:STE 120
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2439
Practice Address - Country:US
Practice Address - Phone:541-393-5983
Practice Address - Fax:541-393-5984
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1314103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist