Provider Demographics
NPI:1043503790
Name:ST. CHARLES, KAREN L (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:L
Last Name:ST. CHARLES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 CEDAR AVE S
Mailing Address - Street 2:MT SI TRANSITIONAL HEALTH CENTER/SPOS NORTH BEND
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045
Mailing Address - Country:US
Mailing Address - Phone:425-888-2129
Mailing Address - Fax:
Practice Address - Street 1:219 CEDAR AVE S
Practice Address - Street 2:MT SI TRANSITIONAL HEALTH CENTER/SPOS NORTH BEND
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045
Practice Address - Country:US
Practice Address - Phone:425-888-2129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00000749225X00000X, 225XG0600X, 225XN1300X, 225XP0019X
WAOT0000749225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation