Individual ProviderBridgette HennigsenSocial WorkerBehavioral Health & Social Service ProvidersPractice Address3810 SE 11th Ave, Portland, OR 97202(503) 542-2721(503) 542-2762PECOS EnrollmentBased on the most recent information from CMS, provider Bridgette Hennigsen does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1134644321Provider TypeIndividualFull NameHennigsen, BridgetteGenderFemaleSole ProprietorNoEnumeration Date8/8/2017Last Updated6/12/2018Contact InformationPractice LocationPractice Address3810 SE 11th Ave, Portland, OR 97202Phone(503) 542-2721FaxUnlisted FaxMailing LocationMailing Address018 SW Boundary Ct, Portland, OR 97239-3939Phone(503) 542-2762FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer