Healthcare Provider Details

I. General information

NPI: 1497592737
Provider Name (Legal Business Name): KATE SAUL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3808 N WILLIAMS AVE STE 134
PORTLAND OR
97227-1468
US

IV. Provider business mailing address

3620 NE 138TH AVE
PORTLAND OR
97230-2963
US

V. Phone/Fax

Practice location:
  • Phone: 503-318-0615
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATE SAUL
Title or Position: OWNER
Credential:
Phone: 503-318-0615