Provider Demographics
NPI:1770525644
Name:ADAMS, KATHLEEN L (PT, CHT)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:L
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2773 NW 9TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-3857
Mailing Address - Country:US
Mailing Address - Phone:541-207-0910
Mailing Address - Fax:541-738-2596
Practice Address - Street 1:2773 NW 9TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3857
Practice Address - Country:US
Practice Address - Phone:541-207-0910
Practice Address - Fax:541-738-2596
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12562251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP94136Medicare UPIN