Provider Demographics
NPI:1760965818
Name:BLAIR, KAITLYN (OTD)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:BLAIR
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1154 NW 2ND CT
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-2005
Mailing Address - Country:US
Mailing Address - Phone:908-268-4089
Mailing Address - Fax:
Practice Address - Street 1:315 OAK ST STE 200
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-2062
Practice Address - Country:US
Practice Address - Phone:541-386-0009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist