Provider Demographics
NPI:1477854750
Name:MCHENRY, ANN MARIE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:
Last Name:MCHENRY
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 NW HOYT ST STE 407
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-2787
Mailing Address - Country:US
Mailing Address - Phone:971-407-3930
Mailing Address - Fax:
Practice Address - Street 1:1306 NW HOYT ST STE 407
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2787
Practice Address - Country:US
Practice Address - Phone:971-407-3930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
ORT1051106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist