Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 1314 | OR |
Y | 103T00000X | Psychologist | 1314 | OR |
NPI | 1003894858 |
---|---|
Provider Name | Dr. Kris S Hallenburg |
First Address | Eugene, OR 97401-2439 |
Second Address | Eugene, OR 97401-2439 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 14/09/2020 |