Provider Demographics
NPI:1760728950
Name:WAXENFELTER, CATHERINE NICOLE (CD)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:NICOLE
Last Name:WAXENFELTER
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19341 WHITNEY LN
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-4243
Mailing Address - Country:US
Mailing Address - Phone:503-557-8348
Mailing Address - Fax:
Practice Address - Street 1:19341 WHITNEY LN
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-4243
Practice Address - Country:US
Practice Address - Phone:503-557-8348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula