Provider Demographics
NPI:1124365507
Name:GERITY, KATE CHASTAIN (LMT)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:CHASTAIN
Last Name:GERITY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 WHEATHERSTONE
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-1916
Mailing Address - Country:US
Mailing Address - Phone:503-699-6636
Mailing Address - Fax:503-594-5033
Practice Address - Street 1:311 B AVE
Practice Address - Street 2:SUITE L
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-3011
Practice Address - Country:US
Practice Address - Phone:503-699-6636
Practice Address - Fax:503-594-5033
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-06
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19443225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist