Provider Demographics
NPI:1174210876
Name:MICHEAU, WENDY LYNN (MS)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LYNN
Last Name:MICHEAU
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:MICHEAU
Other - Last Name:CHUMBLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4804 NW BETHANY BLVD # I2-268
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-9195
Mailing Address - Country:US
Mailing Address - Phone:503-784-1706
Mailing Address - Fax:
Practice Address - Street 1:WENDY MICHEAU
Practice Address - Street 2:16193 NW HILDAGO LN
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-9722
Practice Address - Country:US
Practice Address - Phone:503-927-4387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health