Provider Demographics
NPI:1275674210
Name:SOTTO, KAREN ANNE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ANNE
Last Name:SOTTO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:ANNE
Other - Last Name:GLENWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2313 A ST
Mailing Address - Street 2:
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-1405
Mailing Address - Country:US
Mailing Address - Phone:503-359-7857
Mailing Address - Fax:
Practice Address - Street 1:2313 A ST
Practice Address - Street 2:
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-1405
Practice Address - Country:US
Practice Address - Phone:503-359-7857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7420225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist