Healthcare Provider Details

I. General information

NPI: 1942968672
Provider Name (Legal Business Name): CATALYST PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 NW 2ND ST STE 1
CORVALLIS OR
97330-6487
US

IV. Provider business mailing address

525 NW 2ND ST STE 1
CORVALLIS OR
97330-6487
US

V. Phone/Fax

Practice location:
  • Phone: 541-730-4400
  • Fax: 541-393-2075
Mailing address:
  • Phone: 541-730-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER HAMILTON
Title or Position: CEO
Credential: MD
Phone: 541-730-4400