MEDICARE: RADIANT OSTEOPATHY LLC

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
1	261Q00000X	Clinic/Center
2	204D00000X	Neuromusculoskeletal Medicine & OMM Physician

General Provider Information

NPI Number	:	1396613170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIANT OSTEOPATHY LLC

Provider Business Mailing Address
First Line	:	456 SW MONROE AVE STE 114
Second Line	:
City	:	CORVALLIS
State	:	OR
Zip	:	97333-7207
Country	:	US
Telephone Number	:	541-348-6946
Fax Number	:

Provider Business Practice Location Address
First Line	:	456 SW MONROE AVE STE 114
Second Line	:
City	:	CORVALLIS
State	:	OR
Zip	:	97333-7207
Country	:	US
Telephone Number	:	720-234-7696
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	DR. KATHERINE MERKLE
Credential	:	DO
Telephone Number	:	541-348-6946

Provider Enumeration Date	:	10/24/2025
Last Update Date	:	06/16/2026

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Directions to “RADIANT OSTEOPATHY LLC ” Practice Location

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