Provider Demographics
NPI:1578233045
Name:KLEIBER, BETHANY PATRICIA (DPT)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:PATRICIA
Last Name:KLEIBER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:PATRICIA
Other - Last Name:DOBIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2424 NW HORIZON DR
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-5470
Mailing Address - Country:US
Mailing Address - Phone:503-857-5341
Mailing Address - Fax:
Practice Address - Street 1:525 SE WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-2834
Practice Address - Country:US
Practice Address - Phone:503-017-2121
Practice Address - Fax:503-917-2173
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR06977225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist