Provider Demographics
NPI:1235429051
Name:KLEINWORT, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:KLEINWORT
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 1:28539 SW MEADOWS LOOP
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-8765
Mailing Address - Country:US
Mailing Address - Phone:877-255-0761
Mailing Address - Fax:
Practice Address - Street 1:28539 SW MEADOWS LOOP
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-8765
Practice Address - Country:US
Practice Address - Phone:877-255-0761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor