Healthcare Provider Details

I. General information

NPI: 1861682932
Provider Name (Legal Business Name): KATHERINE E WIGGIN ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 E EVERGREEN BLVD
VANCOUVER WA
98660-3291
US

IV. Provider business mailing address

315 E EVERGREEN BLVD
VANCOUVER WA
98660-3291
US

V. Phone/Fax

Practice location:
  • Phone: 503-449-1167
  • Fax: 888-647-6509
Mailing address:
  • Phone: 503-449-1167
  • Fax: 888-647-6509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1440
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: