Healthcare Provider Details

I. General information

NPI: 1225616998
Provider Name (Legal Business Name): CATHERINE TERESSA FELT FNLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TEESA FELT FNLP

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61237 KING ZEDEKIAH AVE
BEND OR
97702-2807
US

IV. Provider business mailing address

61237 KING ZEDEKIAH AVE
BEND OR
97702-2807
US

V. Phone/Fax

Practice location:
  • Phone: 775-560-6640
  • Fax:
Mailing address:
  • Phone: 775-560-6640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: