Healthcare Provider Details

I. General information

NPI: 1578607016
Provider Name (Legal Business Name): KIM MICHELE LANDI D.C., N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2007
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3165 SW 185TH AVE
BEAVERTON OR
97003-3134
US

IV. Provider business mailing address

3165 SW 185TH AVE
BEAVERTON OR
97003-3134
US

V. Phone/Fax

Practice location:
  • Phone: 503-642-5094
  • Fax: 503-642-5307
Mailing address:
  • Phone: 503-642-5094
  • Fax: 503-642-5307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number26-4050
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2474
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number823
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: