Provider Demographics
NPI:1912491960
Name:KANDA, CATHERINE (DC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:KANDA
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 1:2318 NE 121ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-1840
Mailing Address - Country:US
Mailing Address - Phone:630-546-2020
Mailing Address - Fax:
Practice Address - Street 1:16144 SE HAPPY VALLEY TOWN CENTER DR STE 214
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-4257
Practice Address - Country:US
Practice Address - Phone:503-658-7715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5918111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor