Provider Demographics
NPI:1194380998
Name:GARROW, KENDYL BREE (MSW)
Entity type:Individual
Prefix:
First Name:KENDYL
Middle Name:BREE
Last Name:GARROW
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15700 SW GREYSTONE CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-6011
Mailing Address - Country:US
Mailing Address - Phone:971-262-9150
Mailing Address - Fax:971-262-9151
Practice Address - Street 1:15700 SW GREYSTONE CT
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-6011
Practice Address - Country:US
Practice Address - Phone:971-262-9150
Practice Address - Fax:971-262-9151
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2023-01-30
Deactivation Date:2019-05-07
Deactivation Code:
Reactivation Date:2019-06-21
Provider Licenses
StateLicense IDTaxonomies
ORL108061041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker