Healthcare Provider Details

I. General information

NPI: 1861324626
Provider Name (Legal Business Name): CAMPION PAUL KRAUTTER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 OAKWAY CTR
EUGENE OR
97401-5645
US

IV. Provider business mailing address

1315 E 19TH ST
TULSA OK
74120-7603
US

V. Phone/Fax

Practice location:
  • Phone: 541-687-7005
  • Fax: 541-687-7006
Mailing address:
  • Phone: 918-595-5363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number66110
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: