Provider Demographics
NPI:1518587989
Name:ARNESON, KRISTY PEARL (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:PEARL
Last Name:ARNESON
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 1:3628 SW INNOVATION CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97003-5175
Mailing Address - Country:US
Mailing Address - Phone:503-367-5699
Mailing Address - Fax:
Practice Address - Street 1:4400 SALEM DALLAS HWY NW
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-3338
Practice Address - Country:US
Practice Address - Phone:503-208-6425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-25
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6077111N00000X
OR24084225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist