MEDICARE: DR. KATHLEEN A HALLORAN 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
1	175F00000X	Naturopath	NT00001453	WA

General Provider Information

NPI Number	:	1447372891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHLEEN A HALLORAN ND

Provider Business Mailing Address
First Line	:	PO BOX 507
Second Line	:
City	:	NORTH BEND
State	:	WA
Zip	:	98045-0507
Country	:	US
Telephone Number	:	206-601-2612
Fax Number	:	425-888-0636

Provider Business Practice Location Address
First Line	:	231 BENDIGO BLVD N
Second Line	:
City	:	NORTH BEND
State	:	WA
Zip	:	98045-8259
Country	:	US
Telephone Number	:	425-888-1018
Fax Number	:	425-888-0636

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2007
Last Update Date	:	07/08/2007

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