Kennedy, Michelle B

Kennedy, Michelle B is an individual health care provider with primary practice located at 200 Se Hailey Ave Ste 204 , Pendleton OR 97801-3072. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Kennedy, Michelle B can be contacted via phone (541) 663-4104.

Contact Information

Primary practice address
200 Se Hailey Ave Ste 204 Pendleton OR 97801-3072
Phone: (541) 663-4104
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 25-08-20624 Oregon
Other Service Providers / Peer Specialist 175T00000X 16-CRM-012 Oregon
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 25-QMHA-R-7080 Oregon

Profile Details

NPI number 1578040754
LBN Legal business name Kennedy, Michelle B
Credentials CRM
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2018
Last updated Jan 27th, 2026 - about 9 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578040754 NPPES
Oregon MEDICAID 500790553

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