Provider Demographics
NPI:1639655517
Name:MAY, WENDY ANNA KAUFMAN
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:ANNA KAUFMAN
Last Name:MAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-0010
Mailing Address - Country:US
Mailing Address - Phone:503-266-2970
Mailing Address - Fax:
Practice Address - Street 1:1250 S IVY ST
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-4200
Practice Address - Country:US
Practice Address - Phone:503-266-2970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator