Provider Demographics
NPI:1245633254
Name:REINHARDT, KATIE (DPT)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:REINHARDT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3251 NE SPRING CREEK PL
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7719
Mailing Address - Country:US
Mailing Address - Phone:951-818-7273
Mailing Address - Fax:
Practice Address - Street 1:1714 17TH ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-4410
Practice Address - Country:US
Practice Address - Phone:310-392-7889
Practice Address - Fax:310-314-4431
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41605225100000X
OR64222225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist