Provider Demographics
NPI:1700039153
Name:KASEL, STEVEN (LAC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:KASEL
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11930 SW GREENBURG RD
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-6453
Mailing Address - Country:US
Mailing Address - Phone:503-639-1712
Mailing Address - Fax:971-249-0319
Practice Address - Street 1:11930 SW GREENBURG RD
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6453
Practice Address - Country:US
Practice Address - Phone:503-639-1712
Practice Address - Fax:971-249-0319
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00284171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist