Provider Demographics
NPI:1538110036
Name:GRIFFITH, KAMALA R (DC)
Entity Type:Individual
Prefix:DR
First Name:KAMALA
Middle Name:R
Last Name:GRIFFITH
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 1:3303 SE 147TH PL
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-5386
Mailing Address - Country:US
Mailing Address - Phone:360-885-1757
Mailing Address - Fax:
Practice Address - Street 1:3509 NE 54TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-6423
Practice Address - Country:US
Practice Address - Phone:360-693-8064
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034450111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8852980Medicare PIN
WAV04827Medicare UPIN