Provider Demographics
NPI:1518490226
Name:BIRCH, KATHERYN ELIZABETH (DO)
Entity Type:Individual
Prefix:
First Name:KATHERYN
Middle Name:ELIZABETH
Last Name:BIRCH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KATHERYN
Other - Middle Name:ELIZABETH
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1517
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-0410
Mailing Address - Country:US
Mailing Address - Phone:541-278-4332
Mailing Address - Fax:541-278-8349
Practice Address - Street 1:1488 OAK ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4043
Practice Address - Country:US
Practice Address - Phone:541-683-1577
Practice Address - Fax:541-344-6176
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.0147052080P0201X
390200000X
ORDO2106212080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program