Provider Demographics
NPI:1528491412
Name:WELBERN, KARA MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:MARIE
Last Name:WELBERN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:MARIE
Other - Last Name:MCCLANAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:5200 SW MACADAM
Mailing Address - Street 2:#100
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239
Mailing Address - Country:US
Mailing Address - Phone:503-224-1998
Mailing Address - Fax:503-224-5176
Practice Address - Street 1:5200 SW MACADAM
Practice Address - Street 2:#100
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239
Practice Address - Country:US
Practice Address - Phone:503-224-1998
Practice Address - Fax:503-224-5176
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR311516225X00000X
OR225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist