Provider Demographics
NPI:1568631232
Name:KENDELL, AFTON (LMT)
Entity type:Individual
Prefix:
First Name:AFTON
Middle Name:
Last Name:KENDELL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8005 NE 32ND ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-7297
Mailing Address - Country:US
Mailing Address - Phone:503-758-8820
Mailing Address - Fax:
Practice Address - Street 1:101 NE ROBERTS AVE
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-7551
Practice Address - Country:US
Practice Address - Phone:503-758-8820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2009-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7074172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist