Provider Demographics
NPI:1982846358
Name:STEVENSON, KARA JEAN (PT)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:JEAN
Last Name:STEVENSON
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 1:3025 SW RESERVOIR DR
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-9482
Mailing Address - Country:US
Mailing Address - Phone:541-548-5066
Mailing Address - Fax:
Practice Address - Street 1:3025 SW RESERVOIR DR
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-9482
Practice Address - Country:US
Practice Address - Phone:541-548-5066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4349225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist