Provider Demographics
NPI:1518446962
Name:KASHISHIAN, FAITH LEANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:FAITH
Middle Name:LEANN
Last Name:KASHISHIAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:LEANN
Other - Last Name:PRESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 253
Mailing Address - Street 2:
Mailing Address - City:MERLIN
Mailing Address - State:OR
Mailing Address - Zip Code:97532-0253
Mailing Address - Country:US
Mailing Address - Phone:541-660-6816
Mailing Address - Fax:541-732-8207
Practice Address - Street 1:870 S FRONT ST
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-2779
Practice Address - Country:US
Practice Address - Phone:541-732-8286
Practice Address - Fax:541-732-8207
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19102251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic