Provider Demographics
NPI:1801019070
Name:CREER, KATHRYN (PT)
Entity Type:Individual
Prefix:MISS
First Name:KATHRYN
Middle Name:
Last Name:CREER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 THOMPSON RD
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-2170
Mailing Address - Country:US
Mailing Address - Phone:541-269-7212
Mailing Address - Fax:541-267-5260
Practice Address - Street 1:1650 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-2170
Practice Address - Country:US
Practice Address - Phone:541-269-7212
Practice Address - Fax:541-267-5260
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1313225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist