Provider Demographics
NPI:1417978941
Name:RIFKIN, KENNETH HARVEY (ND, L AC)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:HARVEY
Last Name:RIFKIN
Suffix:
Gender:M
Credentials:ND, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11030 SW CAPITOL HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-8653
Mailing Address - Country:US
Mailing Address - Phone:503-892-8788
Mailing Address - Fax:503-892-9177
Practice Address - Street 1:11030 SW CAPITOL HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-8653
Practice Address - Country:US
Practice Address - Phone:503-892-8788
Practice Address - Fax:503-892-9177
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR40115171100000X
OR0423175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered175F00000XOther Service ProvidersNaturopath