Provider Demographics
NPI:1114215522
Name:MUNSON, KAREN ELIZABETH (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ELIZABETH
Last Name:MUNSON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20845 BRINSON BLVD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-9444
Mailing Address - Country:US
Mailing Address - Phone:541-408-0097
Mailing Address - Fax:
Practice Address - Street 1:2366 NW LAKESIDE PL
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-3535
Practice Address - Country:US
Practice Address - Phone:541-382-0479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11460235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist