Provider Demographics
NPI:1164060703
Name:REIMERS, KRISTYNA ANN (OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTYNA
Middle Name:ANN
Last Name:REIMERS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KRISTYNA
Other - Middle Name:ANN
Other - Last Name:REYNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415-9702
Mailing Address - Country:US
Mailing Address - Phone:541-412-2000
Mailing Address - Fax:
Practice Address - Street 1:7540 N 19TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-7967
Practice Address - Country:US
Practice Address - Phone:888-873-4221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR432991225X00000X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist