Provider Demographics
NPI:1831251594
Name:DANIELS, KAREN (OTR)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 NW HAWTHORNE AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-2958
Mailing Address - Country:US
Mailing Address - Phone:541-330-0302
Mailing Address - Fax:541-330-0302
Practice Address - Street 1:131 NW HAWTHORNE AVE STE 209
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2958
Practice Address - Country:US
Practice Address - Phone:541-330-0302
Practice Address - Fax:541-647-1538
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR969833225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR91-1636085OtherEIN