Provider Demographics
NPI:1205072659
Name:IVERSON, KAREN LYNN (OTR/L, MED)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LYNN
Last Name:IVERSON
Suffix:
Gender:F
Credentials:OTR/L, MED
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:LYNN
Other - Last Name:VEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:11206 CLOVER PARK DR SW APT 25
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-1269
Mailing Address - Country:US
Mailing Address - Phone:253-209-5767
Mailing Address - Fax:
Practice Address - Street 1:5410 184TH. STREET EAST
Practice Address - Street 2:BETHEL SCHOOLS
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387
Practice Address - Country:US
Practice Address - Phone:253-683-6931
Practice Address - Fax:253-683-6992
Is Sole Proprietor?:No
Enumeration Date:2009-01-06
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 00000831174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist