KENNEDY ELIZABETH CHRISTINE - NPI: 1477195261


Mood disorder is a group of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders classification system where a disturbance in the person's mood is hypothesized to be the main underlying feature. The classification is known as mood (affective) disorders in International Classification of Diseases (ICD).

NPI: 1477195261
Entity Type: Person: individual human being who furnishes health care.
Provider First Name: CHRISTINE
Provider Last Name: KENNEDY
Provider Middle Name: ELIZABETH
Provider Gender Code: F
Provider Credential Text: EPDH
Provider Enumeration Date: 10/13/2019
Last Update Date: 10/13/2019

Business Address:

Provider First Line Business Mailing Address: 3514 22ND CT SE
Provider Business Mailing Address City Name: ALBANY
Provider Business Mailing Address State Name: OR
Provider Business Mailing Address Postal Code: 97322
Provider Business Mailing Address Country Code (If outside U.S.): US
Phone: 5416197232

Mailing Address:

Provider First Line Business Practice Location Address: 3000 MARKET ST NE
Provider Business Practice Location Address City Name: SALEM
Provider Business Practice Location Address State Name: OR
Provider Business Practice Location Address Postal Code: 97301
Provider Business Practice Location Address Country Code (If outside U.S.): US
Phone: 5039172604

Primary Taxonomy:

Taxonomy Code: 124Q00000X
License Number: H7637
License State: OR
Healthcare Provider Primary Taxonomy Switch: Y - The taxonomy is the primary taxonomy (there can be only one per NPI record
Type: Dental Providers
Classification: Dental Hygienist
Definition: An individual who has completed an accredited dental hygiene education program
Taxonomy Description: and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist
Source: The National Provider Identifier

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