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Organization
KEREAH CARPENTER DC PC
Active
Organization
KEREAH CARPENTER DC PC
Active
Other names
Carpenter Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEREAH CARPENTER D.C (PRESIDENT)
(503) 642-3423
Entity
Organization
Contact information
Practice address
14355 SW ALLEN BLVD, STE 100, BEAVERTON, OR 97005-4700
(503) 642-3423
Mailing address
14355 SW ALLEN BLVD, STE 100, BEAVERTON, OR 97005-4700
(503) 642-3423
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
27 2818
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050065000
BLUE CROSS BLUE SHIELD
OR
05
—
116900
—
OR
01
—
27 2818
OREGON BOARD OF CHIROPRACTIC EXAMINERS
OR
Enumeration date
05/07/2008
Last updated
08/14/2023
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