Provider Demographics
NPI:1508437153
Name:LUDINGTON, KATHERINE JUNE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:JUNE
Last Name:LUDINGTON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:LUDINGTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:2576 CORTE FACIL
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-5866
Mailing Address - Country:US
Mailing Address - Phone:925-413-5755
Mailing Address - Fax:
Practice Address - Street 1:495 W ARLINGTON ST
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:OR
Practice Address - Zip Code:97027-2308
Practice Address - Country:US
Practice Address - Phone:971-233-0309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR64112225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist