Provider Demographics
NPI:1811401987
Name:KARR, VIRGINIA MARIE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:MARIE
Last Name:KARR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8855 SW HOLLY LN STE 106
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-8792
Mailing Address - Country:US
Mailing Address - Phone:909-559-5925
Mailing Address - Fax:
Practice Address - Street 1:8855 SW HOLLY LN STE 106
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-8792
Practice Address - Country:US
Practice Address - Phone:909-559-5925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16274225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR82-3514142OtherEIN NUMBER