Healthcare Provider Details

I. General information

NPI: 1730367038
Provider Name (Legal Business Name): KATHRYN ALICE PHILLIPS N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 G ST
SPRINGFIELD OR
97477-4113
US

IV. Provider business mailing address

1435 G ST
SPRINGFIELD OR
97477-4113
US

V. Phone/Fax

Practice location:
  • Phone: 541-735-9420
  • Fax:
Mailing address:
  • Phone: 541-735-9420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1597
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: