Provider Demographics
NPI:1750563425
Name:TAUCER, KENT A (OTR/MPA)
Entity type:Individual
Prefix:MR
First Name:KENT
Middle Name:A
Last Name:TAUCER
Suffix:
Gender:M
Credentials:OTR/MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:898 SW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-2627
Mailing Address - Country:US
Mailing Address - Phone:541-881-7337
Mailing Address - Fax:541-881-7334
Practice Address - Street 1:898 SW 4TH AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-2627
Practice Address - Country:US
Practice Address - Phone:541-881-7337
Practice Address - Fax:541-881-7334
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR501544225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist