Provider Demographics
NPI:1144732793
Name:CRAIG, ALISON KAY (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:KAY
Last Name:CRAIG
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:ALISON
Other - Middle Name:KAY
Other - Last Name:FISCHBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:20354 EMPIRE AVE
Mailing Address - Street 2:D5
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703
Mailing Address - Country:US
Mailing Address - Phone:541-728-3857
Mailing Address - Fax:
Practice Address - Street 1:20354 EMPIRE AVE
Practice Address - Street 2:D5
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703
Practice Address - Country:US
Practice Address - Phone:541-728-3857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-03
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR63512225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1753OtherSTATE LICENSING AND REGULATION BOARD
OR500772462Medicaid