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Individual

KENDEL JORDAN BRATCHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3716 SE INTERNATIONAL WAY, MILWAUKIE, OR 97222
(503) 659-0073
Mailing address
13500 SE LINDEN LN #7, MILWAUKIE, OR 97222
(971) 207-5828

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13596
OR

Other

Enumeration date
08/05/2015
Last updated
08/05/2015
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