Provider Demographics
NPI:1891021184
Name:RILEY, KARI (CPM, LDM)
Entity Type:Individual
Prefix:MRS
First Name:KARI
Middle Name:
Last Name:RILEY
Suffix:
Gender:F
Credentials:CPM, LDM
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20530 BARROWS CT
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3064
Mailing Address - Country:US
Mailing Address - Phone:971-533-2444
Mailing Address - Fax:
Practice Address - Street 1:20530 BARROWS CT
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3064
Practice Address - Country:US
Practice Address - Phone:971-533-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2018-12-12
Deactivation Date:2018-10-08
Deactivation Code:
Reactivation Date:2018-12-12
Provider Licenses
StateLicense IDTaxonomies
374J00000X
ORDEM-LD-10191819176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty