Provider Demographics
NPI:1386626414
Name:SZUKALSKI, KARI (MPT)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:SZUKALSKI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1239 NE MEDICAL CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7359
Mailing Address - Country:US
Mailing Address - Phone:541-385-3344
Mailing Address - Fax:541-312-5256
Practice Address - Street 1:1239 NE MEDICAL CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-7359
Practice Address - Country:US
Practice Address - Phone:541-385-3344
Practice Address - Fax:541-312-5256
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4545225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORH254807OtherPACIFIC SOURCE
P00848432OtherPALMETTO RAILROAD MEDICARE
331583OtherPROVIDENCE
OR804449006OtherBCBS
5512846OtherFIRST HEALTH
OR297514Medicaid
ORR152693Medicare PIN