Individual ProviderKathleen DohertyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2201 NW Highland Ave, Grants Pass, OR 97526-3365(224) 456-6017PECOS EnrollmentBased on the most recent information from CMS, provider Kathleen Doherty does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1447068317Provider TypeIndividualFull NameDoherty, KathleenCredentialOTR/LGenderFemaleSole ProprietorYesEnumeration Date12/24/2024Last Updated12/24/2024Contact InformationPractice LocationPractice Address2201 NW Highland Ave, Grants Pass, OR 97526-3365Phone(224) 456-6017FaxUnlisted FaxMailing LocationMailing Address1136 Jeffrey Ct N, Northbrook, IL 60062-4658PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225X00000XPrimaryDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense517848Oregon