Provider Demographics
NPI:1982907671
Name:KAATZ, KAREN LEE (LMT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LEE
Last Name:KAATZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2724 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-4011
Mailing Address - Country:US
Mailing Address - Phone:541-370-5585
Mailing Address - Fax:
Practice Address - Street 1:2724 E 12TH ST
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-4011
Practice Address - Country:US
Practice Address - Phone:541-370-5585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-18
Last Update Date:2010-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11124225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist