| Katherine Jane Petersen, OTR/L | |
|
780 Nw Garden Valley Blvd Ste 310, Roseburg, OR 97471-2298 | |
| (541) 640-7625 | |
| Not Available |
| Full Name | Katherine Jane Petersen |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist - Hand |
| Location | 780 Nw Garden Valley Blvd Ste 310, Roseburg, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861847972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225XH1200X | Occupational Therapist - Hand | 314735 (Oregon) | Primary |
| Provider Name | Icco Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1407004757 PECOS PAC ID: 1355406729 Enrollment ID: O20090218000510 |
| Mailing Address | Practice Location Address |
|---|---|
| Katherine Jane Petersen, OTR/L 1292 High St Ste 224, Eugene, OR 97401-3238 Ph: (541) 500-2500 | Katherine Jane Petersen, OTR/L 780 Nw Garden Valley Blvd Ste 310, Roseburg, OR 97471-2298 Ph: (541) 640-7625 |
Rebecca Irene Moyer, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2198 Ne Stephens St Ste 101, Roseburg, OR 97470 Phone: 541-900-1418 Fax: 541-900-1419 | |
Kyle Ingram, OTR Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 470 Ne Stephens St, Suite 102, Roseburg, OR 97470 Phone: 541-673-5770 Fax: 541-673-5774 | |
Camille E Campanaro, OTD OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1871 Ne Stephens St, Roseburg, OR 97470 Phone: 541-670-6012 | |
Benchmark Physical Therapy Of Or, Llc Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1931 Nw Mulholland Dr, Roseburg, OR 97470 Phone: 541-672-5795 | |
Philip Michael Cusack, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1871 Ne Stephens St, Roseburg, OR 97470 Phone: 541-440-4794 | |
Brock Kolander, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 913 Nw Garden Valley Blvd, Roseburg, OR 97471 Phone: 541-440-1000 | |
James Diemert, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 470 Ne Stephens St, Suite 102, Roseburg, OR 97470 Phone: 541-673-5770 Fax: 541-673-5774 |