Provider Demographics
NPI:1710205950
Name:WILHELM, KATRINA (ND)
Entity Type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:
Last Name:WILHELM
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 1:415 N STATE ST STE 148
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-3244
Mailing Address - Country:US
Mailing Address - Phone:503-683-3588
Mailing Address - Fax:503-210-0366
Practice Address - Street 1:415 N STATE ST STE 148
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-3244
Practice Address - Country:US
Practice Address - Phone:503-683-3588
Practice Address - Fax:503-210-0366
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1738175F00000X
HI218175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath