Provider Demographics
NPI:1447390372
Name:PAGEN, KAREN (PT, CWCE)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PAGEN
Suffix:
Gender:F
Credentials:PT, CWCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 NW WALL ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-1953
Mailing Address - Country:US
Mailing Address - Phone:541-815-3767
Mailing Address - Fax:541-317-9524
Practice Address - Street 1:1012 NW WALL ST
Practice Address - Street 2:SUITE 215
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-1953
Practice Address - Country:US
Practice Address - Phone:541-815-3767
Practice Address - Fax:541-317-9524
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3190225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist