Healthcare Provider Details

I. General information

NPI: 1437151198
Provider Name (Legal Business Name): KARYN MICHELLE STRASEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 03/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 EAST 200 SOUTH VISTA STAFFING SOLUTIONS
SALT LAKE CITY UT
84111
US

IV. Provider business mailing address

1115 SE 164TH AVE DEPT 364
VANCOUVER WA
98683-9324
US

V. Phone/Fax

Practice location:
  • Phone: 800-366-1884
  • Fax:
Mailing address:
  • Phone: 907-225-7346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG61008
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG061008
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number05790
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: