Provider Demographics
NPI:1194714725
Name:KOVAK, KAREN E (MS)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:E
Last Name:KOVAK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 SE 63RD AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-1318
Mailing Address - Country:US
Mailing Address - Phone:503-494-5606
Mailing Address - Fax:503-494-2786
Practice Address - Street 1:707 SW GAINES ST
Practice Address - Street 2:CHILD DEVELOPMENT & REHABILITATION CENTER
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2901
Practice Address - Country:US
Practice Address - Phone:503-494-8307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS