Provider Demographics
NPI:1639220320
Name:KIRNAK, JOCELYN (DC)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:KIRNAK
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 1:5201 SW WESTGATE DR
Mailing Address - Street 2:SUITE 119
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97221
Mailing Address - Country:US
Mailing Address - Phone:503-335-0449
Mailing Address - Fax:503-292-6551
Practice Address - Street 1:5201 SW WESTGATE DR
Practice Address - Street 2:SUITE 119
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97221-2412
Practice Address - Country:US
Practice Address - Phone:503-335-0449
Practice Address - Fax:503-292-6551
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273077111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor