Healthcare Provider Details

I. General information

NPI: 1013871730
Provider Name (Legal Business Name): KATHLEEN ELIZABETH CHRISTENSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2577 NE COURTNEY DR
BEND OR
97701-7752
US

IV. Provider business mailing address

2577 NE COURTNEY DR
BEND OR
97701-7752
US

V. Phone/Fax

Practice location:
  • Phone: 541-322-7400
  • Fax: 541-322-7618
Mailing address:
  • Phone: 541-322-7400
  • Fax: 541-322-7618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number096000695RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: