Provider Demographics
NPI:1053822973
Name:KRAUTSCHEID, KAREN (LMT, CPT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:KRAUTSCHEID
Suffix:
Gender:F
Credentials:LMT, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 962
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97075-0962
Mailing Address - Country:US
Mailing Address - Phone:971-319-1151
Mailing Address - Fax:
Practice Address - Street 1:11080 SW ALLEN BLVD STE 300C
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-4763
Practice Address - Country:US
Practice Address - Phone:971-319-1151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist