Provider Demographics
NPI:1568632578
Name:WALLE, CATHRINE SKOGHEIM (DC, BS)
Entity Type:Individual
Prefix:DR
First Name:CATHRINE
Middle Name:SKOGHEIM
Last Name:WALLE
Suffix:
Gender:F
Credentials:DC, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3014 BLUFF ST
Mailing Address - Street 2:SUITE #100
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2166
Mailing Address - Country:US
Mailing Address - Phone:720-406-9447
Mailing Address - Fax:720-974-1133
Practice Address - Street 1:3014 BLUFF ST
Practice Address - Street 2:SUITE #100
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2166
Practice Address - Country:US
Practice Address - Phone:720-406-9447
Practice Address - Fax:720-974-1133
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program