Provider Demographics
NPI:1669518940
Name:KUNS, WESTLEY MERRILL (DC)
Entity type:Individual
Prefix:DR
First Name:WESTLEY
Middle Name:MERRILL
Last Name:KUNS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 NE DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-3947
Mailing Address - Country:US
Mailing Address - Phone:503-661-0791
Mailing Address - Fax:503-661-1136
Practice Address - Street 1:405 NE DIVISION ST
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-3947
Practice Address - Country:US
Practice Address - Phone:503-661-0791
Practice Address - Fax:503-661-1136
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR272998111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR020588757OtherTAX ID NUMBER
OR0000QGHJTMedicare ID - Type Unspecified
ORUG4932Medicare UPIN