Provider Demographics
NPI:1073838520
Name:MCWHIRTER, CANDACE (LAC)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:MCWHIRTER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 230177
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97281-0177
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7460 SW HUNZIKER ST
Practice Address - Street 2:SUITE D
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8244
Practice Address - Country:US
Practice Address - Phone:503-803-1466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-28
Last Update Date:2010-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC150582171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist