Provider Demographics
NPI:1942331327
Name:LEWIS, CATHERINE I D (DC)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:I D
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 NE 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-1335
Mailing Address - Country:US
Mailing Address - Phone:360-901-3394
Mailing Address - Fax:
Practice Address - Street 1:2217 E EVERGREEN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-4316
Practice Address - Country:US
Practice Address - Phone:360-253-5621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034729111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor