Healthcare Provider Details

I. General information

NPI: 1578504197
Provider Name (Legal Business Name): KATHERINE ZIEMAN N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 01/14/2020
Certification Date: 01/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22400 SE STARK ST STE 105
GRESHAM OR
97030-2656
US

IV. Provider business mailing address

22400 SE STARK ST STE 105
GRESHAM OR
97030-2656
US

V. Phone/Fax

Practice location:
  • Phone: 503-492-1221
  • Fax: 503-200-1094
Mailing address:
  • Phone: 503-492-1221
  • Fax: 503-200-1094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number0799
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW00000181
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number54
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: