Provider Demographics
NPI:1861815318
Name:KAHN, ALEXANDER (LAC, DIPLOM)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:KAHN
Suffix:
Gender:M
Credentials:LAC, DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5331 SW MACADAM AVE
Mailing Address - Street 2:SUITE 380
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239
Mailing Address - Country:US
Mailing Address - Phone:503-849-7156
Mailing Address - Fax:
Practice Address - Street 1:5331 SW MACADAM AVE
Practice Address - Street 2:STE. 380
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-6104
Practice Address - Country:US
Practice Address - Phone:503-849-7156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC166501171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist