Healthcare Provider Details

I. General information

NPI: 1770806903
Provider Name (Legal Business Name): KATHERINE GREER CPM, LDM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 02/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1437 NE EVERETT ST
CAMAS WA
98607-1366
US

IV. Provider business mailing address

1437 NE EVERETT ST
CAMAS WA
98607-1366
US

V. Phone/Fax

Practice location:
  • Phone: 503-473-7207
  • Fax:
Mailing address:
  • Phone: 503-473-7207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberDEM-LD-10132454
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: