Provider Demographics
NPI:1396182580
Name:SILL, KATHERINE M (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:M
Last Name:SILL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-7068
Mailing Address - Country:US
Mailing Address - Phone:971-317-0883
Mailing Address - Fax:971-317-0884
Practice Address - Street 1:2820 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-7068
Practice Address - Country:US
Practice Address - Phone:971-317-0883
Practice Address - Fax:971-317-0884
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5150111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician