Provider Demographics
NPI:1982278255
Name:KENT, LENA (MA)
Entity Type:Individual
Prefix:
First Name:LENA
Middle Name:
Last Name:KENT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6655 SW NYBERG LN UNIT 315
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-8225
Mailing Address - Country:US
Mailing Address - Phone:407-456-0062
Mailing Address - Fax:
Practice Address - Street 1:16500 NW BETHANY CT STE 150
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-6013
Practice Address - Country:US
Practice Address - Phone:503-430-8539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106S00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician