Provider Demographics
NPI:1093051500
Name:JAMES, BARBARA KATHERINE 'KAT' (LMT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:KATHERINE 'KAT'
Last Name:JAMES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:KAT
Other - Middle Name:
Other - Last Name:BIRD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:3126 NW WILSON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-1959
Mailing Address - Country:US
Mailing Address - Phone:323-337-7607
Mailing Address - Fax:
Practice Address - Street 1:2534 NW VAUGHN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2552
Practice Address - Country:US
Practice Address - Phone:323-337-7607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18591225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist