Provider Demographics
NPI:1285001073
Name:MILLER, KENDRA FAYE (DC)
Entity Type:Individual
Prefix:DR
First Name:KENDRA
Middle Name:FAYE
Last Name:MILLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10150 NW GLENCOE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINS
Mailing Address - State:OR
Mailing Address - Zip Code:97133-8226
Mailing Address - Country:US
Mailing Address - Phone:503-336-3335
Mailing Address - Fax:
Practice Address - Street 1:10150 NW GLENCOE RD
Practice Address - Street 2:
Practice Address - City:NORTH PLAINS
Practice Address - State:OR
Practice Address - Zip Code:97133-8226
Practice Address - Country:US
Practice Address - Phone:503-336-3335
Practice Address - Fax:503-336-3648
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007336111N00000X
COEL.2786437111NR0400X
OR5799111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation