Basic Information
| Provider Information | |||||||||
| NPI: | 1730202540 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEMENWAY | ||||||||
| FirstName: | KORY | ||||||||
| MiddleName: | DONNELL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1573 8TH AVE | ||||||||
| Address2: | |||||||||
| City: | WEST LINN | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970684514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105028784 | ||||||||
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| Practice Location | |||||||||
| Address1: | 880 82ND DR | ||||||||
| Address2: | |||||||||
| City: | GLADSTONE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970271803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036595515 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2007 | ||||||||
| LastUpdateDate: | 05/23/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | PSY18855 | CA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.