Provider Demographics
NPI:1033222179
Name:STROUSE, CATHERINE MYRA (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MYRA
Last Name:STROUSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:MYRA
Other - Last Name:STROUSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:12607 SE MILL PLAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-6055
Mailing Address - Country:US
Mailing Address - Phone:866-420-2244
Mailing Address - Fax:360-896-4470
Practice Address - Street 1:12607 SE MILL PLAIN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6055
Practice Address - Country:US
Practice Address - Phone:866-420-2244
Practice Address - Fax:360-896-4470
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00030162207Q00000X
ORMD16254207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine