Provider Demographics
NPI:1043024631
Name:SHAIBAN, KANAR
Entity type:Individual
Prefix:
First Name:KANAR
Middle Name:
Last Name:SHAIBAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 NE JACK LONDON ST UNIT 94
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-6914
Mailing Address - Country:US
Mailing Address - Phone:541-368-8224
Mailing Address - Fax:
Practice Address - Street 1:2601 NE JACK LONDON ST UNIT 94
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-6914
Practice Address - Country:US
Practice Address - Phone:541-368-8224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
No171W00000XOther Service ProvidersContractor