Provider Demographics
NPI:1306092143
Name:CRINER, ROBYN M (PT)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:M
Last Name:CRINER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:M
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2350 NW CENTURY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330
Mailing Address - Country:US
Mailing Address - Phone:541-754-1265
Mailing Address - Fax:541-758-2744
Practice Address - Street 1:2350 NW CENTURY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330
Practice Address - Country:US
Practice Address - Phone:541-754-1265
Practice Address - Fax:541-758-2744
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT34813225100000X
OR6195225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR6195OtherPHYSICAL THERAPY LICENSE
CAPT34813OtherPHYSICAL THERAPY LICENSE