Healthcare Provider Details

I. General information

NPI: 1174897763
Provider Name (Legal Business Name): CATERINA HALL MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2012
Last Update Date: 02/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93670 VIKING LN
NORTH BEND OR
97459-8623
US

IV. Provider business mailing address

715 SW RAMSEY AVE
GRANTS PASS OR
97527-5500
US

V. Phone/Fax

Practice location:
  • Phone: 541-756-8351
  • Fax:
Mailing address:
  • Phone: 541-956-4943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: