Provider Demographics
NPI:1760542336
Name:WAIBEL, KATHRYN SUE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:SUE
Last Name:WAIBEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 SE OAK ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4147
Mailing Address - Country:US
Mailing Address - Phone:503-648-0731
Mailing Address - Fax:
Practice Address - Street 1:545 SE OAK ST
Practice Address - Street 2:SUITE C
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4147
Practice Address - Country:US
Practice Address - Phone:503-648-0731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation