Provider Demographics
NPI:1164160255
Name:TREFF, KAREN ANN CORDATO
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN CORDATO
Last Name:TREFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 NW BUNGALOW DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-5470
Mailing Address - Country:US
Mailing Address - Phone:541-213-9977
Mailing Address - Fax:
Practice Address - Street 1:1569 SW NANCY WAY STE 1
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3234
Practice Address - Country:US
Practice Address - Phone:541-617-0543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional