Provider Demographics
NPI:1497702278
Name:KENOW, LAURA (ATC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:KENOW
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 NW COUNTRY CT
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-9782
Mailing Address - Country:US
Mailing Address - Phone:503-883-2580
Mailing Address - Fax:503-883-2453
Practice Address - Street 1:900 SE BAKER ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-6808
Practice Address - Country:US
Practice Address - Phone:503-883-2580
Practice Address - Fax:503-883-2453
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAT-AT-5210652255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer