Provider Demographics
NPI:1578504197
Name:ZIEMAN, KATHERINE (ND)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:ZIEMAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22400 SE STARK ST STE 105
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-2656
Mailing Address - Country:US
Mailing Address - Phone:503-492-1221
Mailing Address - Fax:503-200-1094
Practice Address - Street 1:22400 SE STARK ST STE 105
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-2656
Practice Address - Country:US
Practice Address - Phone:503-492-1221
Practice Address - Fax:503-200-1094
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW00000181176B00000X
OR54176B00000X
OR0799175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7126659OtherWA PROVIDER ID
WA2145248Medicaid
OR825892000OtherBCBS
ORMW00000181OtherWA MIDWIFE
OR126669Medicaid