Provider Demographics
NPI:1114957099
Name:MCLACHLAN, KATHERINE KNOWLES (CPM, LDEM)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:KNOWLES
Last Name:MCLACHLAN
Suffix:
Gender:F
Credentials:CPM, LDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 SE GRANT ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-5411
Mailing Address - Country:US
Mailing Address - Phone:503-234-3243
Mailing Address - Fax:
Practice Address - Street 1:2045 SE GRANT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-5411
Practice Address - Country:US
Practice Address - Phone:503-234-3243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDEM-LD-375485175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR278662Medicaid