Provider Demographics
NPI:1477921021
Name:RICH, KARA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:RICH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1706 NE 114TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-1911
Mailing Address - Country:US
Mailing Address - Phone:607-423-5534
Mailing Address - Fax:
Practice Address - Street 1:1706 NE 114TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220
Practice Address - Country:US
Practice Address - Phone:607-423-5534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-11
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR60544208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation