| Doctor Name: | KATHLEEN M HENNESSY |
| NPI Number: | 1124357678 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 146154 |
| Business Practice Address: | 6160 Sw Arctic Dr Beaverton, OR - 970059448 |
| Business Phone Number: | 5036467777 |
| Business Fax Number: | |
| Mailing Address: | Po Box 66500, PORTLAND |
| State: | OR |
| Postal Code: | 972906500 |
| Phone Number: | 5036578663 |
| Fax Number: | 5037233180 |
| NPI Enumeration Date: | 12/11/2009 |
| NPI Last Update Date: | 12/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 247100000X |
| License Number: | 146154 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |