Healthcare Provider Details

I. General information

NPI: 1881300291
Provider Name (Legal Business Name): KATHRYN RENEE SKOGLUN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 OLIVE ST
CASHMERE WA
98815-1125
US

IV. Provider business mailing address

PO BOX 3603
WENATCHEE WA
98807-3603
US

V. Phone/Fax

Practice location:
  • Phone: 509-860-2365
  • Fax:
Mailing address:
  • Phone: 509-860-2365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH61479046
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: