Provider Demographics
NPI:1891808788
Name:KINPORTS, KATHERINE LYN (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:LYN
Last Name:KINPORTS
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 1:2432 BORDERS DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-3838
Mailing Address - Country:US
Mailing Address - Phone:503-887-8079
Mailing Address - Fax:
Practice Address - Street 1:1355 OAK ST STE 100
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3566
Practice Address - Country:US
Practice Address - Phone:541-683-1125
Practice Address - Fax:541-683-2049
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR71-3648111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor