Provider Demographics
NPI:1992267843
Name:KNIGHT, KERRI LYN (OTR/L)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:LYN
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:LYN
Other - Last Name:BEER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5657 WALNWOOD CT SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-1654
Mailing Address - Country:US
Mailing Address - Phone:916-505-5008
Mailing Address - Fax:
Practice Address - Street 1:1475 CAPITOL ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-7850
Practice Address - Country:US
Practice Address - Phone:971-599-1712
Practice Address - Fax:888-835-4257
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR295385225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist