Healthcare Provider Details

I. General information

NPI: 1457995284
Provider Name (Legal Business Name): MADISON KATHERINE MUHLHAUSER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2019
Last Update Date: 11/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 FRANKLIN ST STE 200
VANCOUVER WA
98660-3356
US

IV. Provider business mailing address

800 FRANKLIN ST STE 200
VANCOUVER WA
98660-3356
US

V. Phone/Fax

Practice location:
  • Phone: 360-828-1429
  • Fax:
Mailing address:
  • Phone: 360-989-5870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: