Provider Demographics
NPI:1063217784
Name:KNIGHT, KARA (LMT)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:KNIGHT
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:
Other - Last Name:NIGHTINGALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:1155 HARLEM ST SE
Mailing Address - Street 2:
Mailing Address - City:BANDON
Mailing Address - State:OR
Mailing Address - Zip Code:97411-9103
Mailing Address - Country:US
Mailing Address - Phone:541-329-9444
Mailing Address - Fax:
Practice Address - Street 1:1125 ALABAMA AVE SE
Practice Address - Street 2:
Practice Address - City:BANDON
Practice Address - State:OR
Practice Address - Zip Code:97411-9105
Practice Address - Country:US
Practice Address - Phone:541-329-9444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR26904225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist