Healthcare Provider Details

I. General information

NPI: 1720366883
Provider Name (Legal Business Name): NAZANIN KAATZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2011
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 NW 11TH ST
HERMISTON OR
97838-6601
US

IV. Provider business mailing address

610 NW 11TH ST
HERMISTON OR
97838-6601
US

V. Phone/Fax

Practice location:
  • Phone: 541-289-4153
  • Fax: 458-219-3125
Mailing address:
  • Phone: 541-289-4153
  • Fax: 458-219-3125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD61211976
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR72567
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD229460
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberTL.0006955
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: