Healthcare Provider Details

I. General information

NPI: 1134415292
Provider Name (Legal Business Name): KATHERINE MERKLE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2011
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
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 TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO176533
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberDO176533
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: