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NPI Code Detail

MEDICARE: KATHERINE LEAVENS ND

MEDICARE: KATHERINE LEAVENS ND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturist
2175F00000XNaturopath5023OR

General Provider Information

NPI Number : 1184404246
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE LEAVENS ND
Provider Business Mailing Address
First Line : 4114 NE ROYAL CT APT A
Second Line :
City : PORTLAND
State : OR
Zip : 97232-2677
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2330 NW FLANDERS ST STE 101
Second Line :
City : PORTLAND
State : OR
Zip : 97210-3400
Country : US
Telephone Number : 503-701-8766
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2023
Last Update Date : 10/04/2023

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Directions to “ KATHERINE LEAVENS ND” Practice Location

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