Provider Demographics
NPI:1881300291
Name:SKOGLUN, KATHRYN RENEE (DC)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:RENEE
Last Name:SKOGLUN
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:PO BOX 3603
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98807-3603
Mailing Address - Country:US
Mailing Address - Phone:509-860-2365
Mailing Address - Fax:
Practice Address - Street 1:222 OLIVE ST
Practice Address - Street 2:
Practice Address - City:CASHMERE
Practice Address - State:WA
Practice Address - Zip Code:98815-1125
Practice Address - Country:US
Practice Address - Phone:509-860-2365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61479046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor