Healthcare Provider Details

I. General information

NPI: 1467440321
Provider Name (Legal Business Name): KATIE ESTER TIHANYI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 WALLACE RD NW
SALEM OR
97304-3007
US

IV. Provider business mailing address

1255 WALLACE RD NW
SALEM OR
97304-3007
US

V. Phone/Fax

Practice location:
  • Phone: 503-362-1314
  • Fax: 503-362-5895
Mailing address:
  • Phone: 503-362-1314
  • Fax: 503-362-5895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13740
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: