Individual
MS. KAREN JEAN WALZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
413 NW LARCH AVE, SUITE 102, REDMOND, OR 97756-1361
(541) 923-7494
(541) 504-9153
Mailing address
16083 SW UPPER BOONES FERRY RD, STE. 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
12280
CA
225100000X
Physical Therapist
Primary
1400
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31604
—
OR
01
—
650012931
RR MEDICARE
OR
01
—
P00995520
RR MEDICARE
OR
Enumeration date
12/13/2005
Last updated
11/13/2012
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