Healthcare Provider Details

I. General information

NPI: 1396613170
Provider Name (Legal Business Name): RADIANT OSTEOPATHY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2025
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 SW MONROE AVE STE 114
CORVALLIS OR
97333-7207
US

IV. Provider business mailing address

456 SW MONROE AVE STE 114
CORVALLIS OR
97333-7207
US

V. Phone/Fax

Practice location:
  • Phone: 720-234-7696
  • Fax:
Mailing address:
  • Phone: 541-348-6946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KATHERINE MERKLE
Title or Position: OWNER/PROVIDER
Credential: DO
Phone: 541-348-6946