Individual
DR. KENNETH LEE CRANDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
11657 NE GLISAN, PORTLAND, OR 97220
(503) 252-5118
(503) 252-3199
Mailing address
11657 NE GLISAN, PORTLAND, OR 97220
(503) 252-5118
(503) 252-3199
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1923
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
072702
—
OR
Enumeration date
06/28/2006
Last updated
11/16/2011
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