Provider Demographics
NPI:1790555415
Name:CHATWIN, KATIE
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:CHATWIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19450 HOLLYGRAPE ST
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-2876
Mailing Address - Country:US
Mailing Address - Phone:808-497-1593
Mailing Address - Fax:
Practice Address - Street 1:19450 HOLLYGRAPE ST
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-2876
Practice Address - Country:US
Practice Address - Phone:808-497-1593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORTHW000110194374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula