| Doctor Name: | KIM A WENNHOLD |
| NPI Number: | 1053331926 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | MD21250 |
| Business Practice Address: | 998 Library Ct Oregon City, OR - 970454041 |
| Business Phone Number: | 5036558401 |
| Business Fax Number: | 5036558429 |
| Mailing Address: | 2051 Kaen Rd, Suite 367 OREGON CITY |
| State: | OR |
| Postal Code: | 970454035 |
| Phone Number: | 5037425300 |
| Fax Number: | 5036558250 |
| NPI Enumeration Date: | 07/20/2006 |
| NPI Last Update Date: | 11/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084P0804X |
| License Number: | MD21250 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Child & Adolescent Psychiatry |
| Taxonomy Definition: | Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |