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NPI Code Detail

MEDICARE: PHILLIP WILLIAM HENSON

MEDICARE: PHILLIP WILLIAM HENSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist1685OR

General Provider Information

NPI Number : 1316881766
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP WILLIAM HENSON
Provider Business Mailing Address
First Line : 3083 NE 49TH PL
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-6006
Country : US
Telephone Number : 503-704-2645
Fax Number :
Provider Business Practice Location Address
First Line : 3083 NE 49TH PL
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-6006
Country : US
Telephone Number : 503-704-2645
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2026
Last Update Date : 06/02/2026

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