Provider Demographics
NPI:1821581489
Name:STEWART, KATHERINE ANN
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:STEWART
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 1:364 SE GILHAM AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-1426
Mailing Address - Country:US
Mailing Address - Phone:503-309-8577
Mailing Address - Fax:
Practice Address - Street 1:364 SE GILHAM AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-1426
Practice Address - Country:US
Practice Address - Phone:503-309-8577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula