Provider Demographics
NPI:1689642381
Name:MURPHY, KENNETH THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:THOMAS
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 NE 12TH AVE
Mailing Address - Street 2:STE. 203
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2717
Mailing Address - Country:US
Mailing Address - Phone:503-235-4479
Mailing Address - Fax:503-234-2252
Practice Address - Street 1:407 NE 12TH AVE
Practice Address - Street 2:STE. 203
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2717
Practice Address - Country:US
Practice Address - Phone:503-235-4479
Practice Address - Fax:503-234-2252
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR 27-2759111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor