Provider Demographics
NPI:1497747802
Name:KRAMER, KAY LYNN (OTRL, CHT)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:LYNN
Last Name:KRAMER
Suffix:
Gender:F
Credentials:OTRL, CHT
Other - Prefix:
Other - First Name:NOT
Other - Middle Name:
Other - Last Name:APPLICABLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT/BP
Mailing Address - Street 1:2360 MULLAN RD
Mailing Address - Street 2:STE D
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-1811
Mailing Address - Country:US
Mailing Address - Phone:406-541-4263
Mailing Address - Fax:406-541-4264
Practice Address - Street 1:2360 MULLAN RD
Practice Address - Street 2:STE D
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1811
Practice Address - Country:US
Practice Address - Phone:406-541-4263
Practice Address - Fax:406-541-4264
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT51225X00000X, 225XP0200X
1011100304225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0348092Medicaid
MT670001888OtherRAILROAD MEDICARE
MT661230OtherBCBS
MT4500840001Medicare NSC
MT0348092Medicaid