Provider Demographics
NPI:1811185069
Name:WRIGHT, KAREN D
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:D
Last Name:WRIGHT
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:PO BOX 820466
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-0010
Mailing Address - Country:US
Mailing Address - Phone:360-574-3668
Mailing Address - Fax:
Practice Address - Street 1:1412 NE 134TH ST
Practice Address - Street 2:SUITE 260
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-2719
Practice Address - Country:US
Practice Address - Phone:360-574-3668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024729225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist