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General NPI Number Information
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NPI Number | 1811026719
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Entity Type | Individual
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Provider Name | KATHERINE HESS PHILLIPS O.D.
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 5335 MEADOWS RD SUITE 151
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-3398
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Country | US
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Telephone | 503-684-1280
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Fax |
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Provider Business Mailing Address
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Address Line | 7535 SW BARNES RD STE 111
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City | PORTLAND
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State | OR
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Zip | 97225-6269
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Country | US
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Telephone | 503-297-3233
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3123ATI
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License Number State | OR
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