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General NPI Number Information
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NPI Number | 1609161447
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Entity Type | Individual
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Provider Name | CHANTEL LEE LEDERBRAND DC
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Gender | Female
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 446 E MAIN ST
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City | HILLSBORO
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State | OR
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Zip | 97123-4187
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Country | US
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Telephone | 503-530-9161
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Fax |
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Provider Business Mailing Address
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Address Line | 32950 SW BRIDGES RD
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City | HILLSBORO
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State | OR
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Zip | 97123-5534
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Country | US
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Telephone | 503-530-9161
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4116
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License Number State | OR
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