Provider Demographics
NPI:1639485279
Name:BUCHHOLZ, KENDRA L (DC)
Entity Type:Individual
Prefix:DR
First Name:KENDRA
Middle Name:L
Last Name:BUCHHOLZ
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 1:13028 INTERURBAN AVE S
Mailing Address - Street 2:SUITE 106
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-3340
Mailing Address - Country:US
Mailing Address - Phone:206-957-7950
Mailing Address - Fax:206-957-7952
Practice Address - Street 1:13028 INTERURBAN AVE S
Practice Address - Street 2:SUITE 106
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-3340
Practice Address - Country:US
Practice Address - Phone:206-957-7950
Practice Address - Fax:206-957-7952
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60502337111N00000X
WI4644-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor