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General NPI Number Information
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NPI Number | 1134583149
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Entity Type | Organization
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Legal Business Name | KANNACT HEALTH LLC
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 2121 NE JACK LONDON ST STE 200
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City | CORVALLIS
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State | OR
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Zip | 97330-6947
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Country | US
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Telephone | 855-722-5513
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Fax | 541-230-1189
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Provider Business Mailing Address
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Address Line | 2211 NW PROFESSIONAL DR
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City | CORVALLIS
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State | OR
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Zip | 97330-3891
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Country | US
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Telephone | 855-722-5513
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Fax | 541-230-1189
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Authorized Official
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Title or Position | CEO
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Name | KRISHNA RAO
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Credential |
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Telephone | 971-361-6091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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