Provider Demographics
NPI:1790557692
Name:KANDCER, TONI (DC)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:KANDCER
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 1:9701 SE JOHNSON CREEK BLVD APT L106
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-3694
Mailing Address - Country:US
Mailing Address - Phone:831-747-4494
Mailing Address - Fax:
Practice Address - Street 1:20508 SW ROY ROGERS RD # C-115
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9932
Practice Address - Country:US
Practice Address - Phone:503-906-3585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6324111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor