Provider Demographics
NPI:1740206770
Name:KRUEGER, CHRISTINE A (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:A
Other - Last Name:BRANDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:345 NW 84TH PL
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-6775
Mailing Address - Country:US
Mailing Address - Phone:503-292-6148
Mailing Address - Fax:503-227-7548
Practice Address - Street 1:1630 SW MORRISON ST
Practice Address - Street 2:SUITE100
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-1916
Practice Address - Country:US
Practice Address - Phone:503-227-7774
Practice Address - Fax:503-227-7548
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1988225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist