Healthcare Provider Details

I. General information

NPI: 1679681035
Provider Name (Legal Business Name): KATHI NORMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 07/25/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7515 FALCON CREST DR # 200
REDMOND OR
97756-5014
US

IV. Provider business mailing address

7515 FALCON CREST DR # 200
REDMOND OR
97756-5014
US

V. Phone/Fax

Practice location:
  • Phone: 541-904-5216
  • Fax: 541-527-4347
Mailing address:
  • Phone: 541-904-5216
  • Fax: 541-527-4347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA0000000970
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number133447
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9103873
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA156252
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: