Kenneth Lee Crandell, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1923 Issued in OR

Practice address

11657 NE Glisan
Portland, OR 97220

Phone

(503) 252-5118

Fax

(503) 252-3199

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kenneth Crandell, D.C.

  • Chiropractor
  • Portland, OR
  • NPI 1487827978
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1225066632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11657 NE GLISAN",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97220",
            "telephone_number": "503-252-5118",
            "fax_number": "503-252-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11657 NE GLISAN",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97220",
            "telephone_number": "503-252-5118",
            "fax_number": "503-252-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDELL",
        "first_name": "KENNETH",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "1923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "072702",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurie Louise Crandall-Bass, MA
• Jacqulyn Lee Crandall
• Jonathan Crandall, CRNA
• Hollie Kathleen Crandell
• Josie Linda Crandell, PTA, CCA
• Lena Crandell, WHNP
• Cameo McKenzie Crane
• Diana Crane
• Jason Eric Crane, LMT
• Jenner Crane

• Chiropractor in Portland, OR
• Providers in Portland, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.