Provider Demographics
NPI:1043442205
Name:AMACHER, KATIE (LMT)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:AMACHER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8755 SW CITIZENS DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-8405
Mailing Address - Country:US
Mailing Address - Phone:503-682-1110
Mailing Address - Fax:503-682-1118
Practice Address - Street 1:8755 SW CITIZENS DR
Practice Address - Street 2:SUITE 102
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-8405
Practice Address - Country:US
Practice Address - Phone:503-682-1110
Practice Address - Fax:503-682-1118
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16164172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist