Provider Demographics
NPI:1649630781
Name:KANNACT INC.
Entity type:Organization
Organization Name:KANNACT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-361-6091
Mailing Address - Street 1:2211 NW PROFESSIONAL DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-3891
Mailing Address - Country:US
Mailing Address - Phone:185-572-2551
Mailing Address - Fax:541-230-1189
Practice Address - Street 1:2121 NE JACK LONDON ST STE 200
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-6947
Practice Address - Country:US
Practice Address - Phone:185-572-2551
Practice Address - Fax:541-230-1189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies