Provider Demographics
NPI:1891997003
Name:KEENEY, CYNTHIA JOAN (OTR)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:JOAN
Last Name:KEENEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:CYNTHIA
Other - Middle Name:JOAN
Other - Last Name:ALVARADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:7721 SW 34TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-1725
Mailing Address - Country:US
Mailing Address - Phone:503-452-7767
Mailing Address - Fax:503-452-7766
Practice Address - Street 1:7721 SW 34TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-1725
Practice Address - Country:US
Practice Address - Phone:503-452-7767
Practice Address - Fax:503-452-7766
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR529339225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist