Provider Demographics
NPI:1649673054
Name:PERRY, KAREN IRENE
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:IRENE
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 SW RAMSEY AVE
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5500
Mailing Address - Country:US
Mailing Address - Phone:541-956-4943
Mailing Address - Fax:541-956-4963
Practice Address - Street 1:345 N BARTLETT ST
Practice Address - Street 2:SUITE 203
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-5957
Practice Address - Country:US
Practice Address - Phone:541-956-4943
Practice Address - Fax:541-956-4963
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical