Basic Information
Provider Information
NPI: 1760688790
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRIONFANTE
FirstName: KARENYA
MiddleName: MICHELE
NamePrefix: MS.
NameSuffix:  
Credential: OTRL
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ROBINSON
OtherFirstName: KAREN
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 4560 SE INTERNATIONAL WAY
Address2: SUITE 100 CONSONUS HEALTHCARE SERVICES
City: MILWAUKIE
State: OR
PostalCode: 97222
CountryCode: US
TelephoneNumber: 9712065129
FaxNumber: 9712065209
Practice Location
Address1: 4560 SE INTERNATIONAL WAY
Address2: SUITE 100 CONSONUS HEALTHCARE SERVICES
City: MILWAUKIE
State: OR
PostalCode: 97222
CountryCode: US
TelephoneNumber: 9712065129
FaxNumber: 9712065209
Other Information
ProviderEnumerationDate: 06/26/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOT041IDY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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