Provider Demographics
NPI:1225463276
Name:BAUMGARTNER, KATRINA E (LCCE, CD, CPD,)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:E
Last Name:BAUMGARTNER
Suffix:
Gender:F
Credentials:LCCE, CD, CPD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 SE CESAR E CHAVEZ BLVD APT 122
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-3595
Mailing Address - Country:US
Mailing Address - Phone:603-209-3063
Mailing Address - Fax:
Practice Address - Street 1:700 SE CESAR E CHAVEZ BLVD APT 122
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-3595
Practice Address - Country:US
Practice Address - Phone:603-209-3063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-10
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No174H00000XOther Service ProvidersHealth Educator
No374J00000XNursing Service Related ProvidersDoula