Provider Demographics
NPI:1073854311
Name:YATES, KARLA B (OTR)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:B
Last Name:YATES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8909 SW PASTURE CT.
Mailing Address - Street 2:
Mailing Address - City:TERREBONNE
Mailing Address - State:OR
Mailing Address - Zip Code:97760
Mailing Address - Country:US
Mailing Address - Phone:541-647-4338
Mailing Address - Fax:
Practice Address - Street 1:7320 SW HUNZZIKER, SUITE 203
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223
Practice Address - Country:US
Practice Address - Phone:888-317-1019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR985863225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation