Provider Demographics
NPI:1326485863
Name:MONROE, KAREN M (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:M
Last Name:MONROE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N GARDEN CT
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-4318
Mailing Address - Country:US
Mailing Address - Phone:509-769-6325
Mailing Address - Fax:
Practice Address - Street 1:1253 POPLAR ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-2248
Practice Address - Country:US
Practice Address - Phone:509-769-6325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0003456174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist