Provider Demographics
NPI:1164090841
Name:PEARSON, KATHERINE LOUISE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:LOUISE
Last Name:PEARSON
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 1:5200 S MACADAM AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3843
Mailing Address - Country:US
Mailing Address - Phone:503-224-1998
Mailing Address - Fax:503-224-5176
Practice Address - Street 1:5200 S MACADAM AVE STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3843
Practice Address - Country:US
Practice Address - Phone:503-224-1998
Practice Address - Fax:503-224-5176
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR402220225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist