Provider Demographics
NPI:1639667454
Name:BUCHNER, KENDRA JOANNE
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:JOANNE
Last Name:BUCHNER
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 1:1036 SE DOUGLAS AVE # 221
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-3301
Mailing Address - Country:US
Mailing Address - Phone:541-440-3677
Mailing Address - Fax:541-440-3658
Practice Address - Street 1:1036 SE DOUGLAS AVE # 221
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-3301
Practice Address - Country:US
Practice Address - Phone:541-440-3677
Practice Address - Fax:541-440-3658
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator