Provider Demographics
NPI:1144551904
Name:MERCER, KATHRYN MARY (ND)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:MARY
Last Name:MERCER
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 1:716 SW HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-3120
Mailing Address - Country:US
Mailing Address - Phone:541-516-1045
Mailing Address - Fax:541-516-1047
Practice Address - Street 1:716 SW HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-3120
Practice Address - Country:US
Practice Address - Phone:541-516-1045
Practice Address - Fax:541-516-1047
Is Sole Proprietor?:No
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1724175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath