Organization
KENNETH CRANDELL, D.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH LEE CRANDELL D.C. (OWNER)
(503) 252-5118
Entity
Organization
Contact information
Practice address
11657 NE GLISAN ST, PORTLAND, OR 97220-2264
(503) 252-5118
(503) 252-3199
Mailing address
11657 NE GLISAN ST, PORTLAND, OR 97220-2264
(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
04/07/2008
Last updated
04/07/2008
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