Provider Demographics
NPI:1295081727
Name:NEUBAUER, KATHERINE (ND)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:NEUBAUER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 NE FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4918
Mailing Address - Country:US
Mailing Address - Phone:541-323-2833
Mailing Address - Fax:541-797-7740
Practice Address - Street 1:403 NE FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4918
Practice Address - Country:US
Practice Address - Phone:541-323-2833
Practice Address - Fax:541-797-7740
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2018175F00000X
AZ08-1053175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR2018OtherLICENSE