Provider Demographics
NPI:1548490980
Name:KINATEDER, JAMES MICHAEL (MT (ASCP))
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MICHAEL
Last Name:KINATEDER
Suffix:
Gender:F
Credentials:MT (ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2668 NW SHANTEL ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-2976
Mailing Address - Country:US
Mailing Address - Phone:541-580-6098
Mailing Address - Fax:
Practice Address - Street 1:2668 NW SHANTEL ST APT 2
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-2976
Practice Address - Country:US
Practice Address - Phone:541-580-6098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist