Healthcare Provider Details

I. General information

NPI: 1144551904
Provider Name (Legal Business Name): KATHRYN MARY MERCER N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2010
Last Update Date: 01/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 SW HIGHLAND AVE
REDMOND OR
97756-3120
US

IV. Provider business mailing address

716 SW HIGHLAND AVE
REDMOND OR
97756-3120
US

V. Phone/Fax

Practice location:
  • Phone: 541-516-1045
  • Fax: 541-516-1047
Mailing address:
  • Phone: 541-516-1045
  • Fax: 541-516-1047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1724
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: