Provider Demographics
NPI:1508231788
Name:KUTSAR, VICTOR V (DC)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:V
Last Name:KUTSAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 SE 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-2428
Mailing Address - Country:US
Mailing Address - Phone:971-544-7058
Mailing Address - Fax:971-244-9058
Practice Address - Street 1:3611 MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-1932
Practice Address - Country:US
Practice Address - Phone:816-561-7035
Practice Address - Fax:816-203-4819
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6238111N00000X
OR21766225700000X
MO2023049802111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist