Kenneth Crandell, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1923 Issued in OR

Legal business name

KENNETH CRANDELL, D.C.

Practice address

11657 NE Glisan St
Portland, OR 97220-2264

Phone

(503) 252-5118

Fax

(503) 252-3199

NPI assigned

Apr 7, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Lee Crandell, D.C.NPI 1225066632

Title

Owner

Phone

(503) 252-5118

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Lee Crandell, DC

  • Chiropractor
  • Portland, OR
  • NPI 1225066632
  NPD (past) Authorized official

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1487827978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11657 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202264",
            "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 ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202264",
            "telephone_number": "503-252-5118",
            "fax_number": "503-252-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH CRANDELL, D.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "CRANDELL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-252-5118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "1923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "072702",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shiletha Kennedy
• Terence Kennedy
• William J Kennedy, DO
• Thomas M Kennefick, MD
• Alice Da Palma Kennerly
• Kailin Kenney
• Karee Kenney, M.S.P.T.
• McCrae Nathanial Kenney
• Philip Simmons Kenney, MS LPC
• Erin Alyssa Kenning, L.AC.

• 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 Apr 7, 2008; 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.