Provider Demographics
NPI:1770520892
Name:DEMING, KATIE ANNE (MD)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:ANNE
Last Name:DEMING
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1400 NW IRVING ST
Mailing Address - Street 2:527
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-2210
Mailing Address - Country:US
Mailing Address - Phone:503-222-1299
Mailing Address - Fax:503-222-2349
Practice Address - Street 1:1400 NW IRVING ST
Practice Address - Street 2:527
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2210
Practice Address - Country:US
Practice Address - Phone:503-222-1299
Practice Address - Fax:503-222-2349
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2022-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD265682085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR134987Medicare PIN