Healthcare Provider Details

I. General information

NPI: 1164393906
Provider Name (Legal Business Name): CATHERINE EARL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MATILDA EARL

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 DIVISION AVE STE T
EUGENE OR
97404-2485
US

IV. Provider business mailing address

1820 OLIVE ST
EUGENE OR
97401-3856
US

V. Phone/Fax

Practice location:
  • Phone: 541-418-4590
  • Fax:
Mailing address:
  • Phone: 541-206-4353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number8902
License Number StateTN

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: