Individual
DR. NICOLE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
5253 NE SANDY BLVD, PORTLAND, OR 97213-2562
(503) 893-5131
Mailing address
25365 NW MORELAND RD, NORTH PLAINS, OR 97133-9206
(971) 232-1566
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5855
OR
Other
Enumeration date
12/13/2017
Last updated
10/07/2019
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