Provider Demographics
NPI:1437451267
Name:BRENNAN, KRISTEN ANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:ANNE
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KRISTEN
Other - Middle Name:ANNE
Other - Last Name:WILBUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 1566
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140
Mailing Address - Country:US
Mailing Address - Phone:503-625-0152
Mailing Address - Fax:503-625-0153
Practice Address - Street 1:558 SE 10TH STREET
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4625
Practice Address - Country:US
Practice Address - Phone:503-601-0210
Practice Address - Fax:503-601-0551
Is Sole Proprietor?:No
Enumeration Date:2010-11-30
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4061111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor