Provider Demographics
NPI:1467440321
Name:TIHANYI, KATIE ESTER (MD)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ESTER
Last Name:TIHANYI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 WALLACE RD NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-3007
Mailing Address - Country:US
Mailing Address - Phone:503-362-1314
Mailing Address - Fax:503-362-5895
Practice Address - Street 1:1255 WALLACE RD NW
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-3007
Practice Address - Country:US
Practice Address - Phone:503-362-1314
Practice Address - Fax:503-362-5895
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13740207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR019179Medicaid
ORD26347Medicare UPIN
OR019179Medicaid