Healthcare Provider Details

I. General information

NPI: 1851826366
Provider Name (Legal Business Name): KATHLEEN MARY OJEDA ND, LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2017
Last Update Date: 02/21/2022
Certification Date: 02/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 S GRAND AVE
PULLMAN WA
99163-2751
US

IV. Provider business mailing address

425 S GRAND AVE
PULLMAN WA
99163-2751
US

V. Phone/Fax

Practice location:
  • Phone: 509-330-5399
  • Fax:
Mailing address:
  • Phone: 763-486-2934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT 60749831
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW61201293
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: