Doctor Name: | MR. PATRICK WILLIAM KINCAID |
NPI Number: | 1033345517 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | 5935 |
Business Practice Address: | 270 N Molalla Ave Molalla, OR - 970388841 |
Business Phone Number: | 5036985500 |
Business Fax Number: | 5035574871 |
Mailing Address: | 14851 Se 82nd Dr, CLACKAMAS |
State: | OR |
Postal Code: | 970157624 |
Phone Number: | 5036985500 |
Fax Number: | 5035574871 |
NPI Enumeration Date: | 06/10/2009 |
NPI Last Update Date: | 06/10/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 5935 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |