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General NPI Number Information
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NPI Number | 1821015637
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Entity Type | Organization
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Legal Business Name | KP CHIROPRACTIC SERVICES PC
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 03/21/2008
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Provider Practice Location Address
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Address Line | 4309 OAKRIDGE RD
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-3418
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Country | US
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Telephone | 503-635-4656
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Fax | 503-635-4281
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Provider Business Mailing Address
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Address Line | 4309 OAKRIDGE RD
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-3418
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Country | US
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Telephone | 503-635-4656
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Fax | 503-635-4281
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Authorized Official
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Title or Position | PRESIDENT ATTENDING CHIROPRACTOR
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Name | DR. KRIS POLLACK
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Credential | DC
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Telephone | 503-635-4656
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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 | 3427
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License Number State | OR
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