Provider Demographics
NPI:1538213723
Name:HILL, KATHRYN MAE (WHCNP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MAE
Last Name:HILL
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:847 NE 19TH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2684
Mailing Address - Country:US
Mailing Address - Phone:503-963-2801
Mailing Address - Fax:503-963-2825
Practice Address - Street 1:9155 SW BARNES RD STE 735
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6634
Practice Address - Country:US
Practice Address - Phone:503-297-4123
Practice Address - Fax:503-297-0344
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR095006627RN363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500616272Medicaid
WA2038733Medicaid
ORP01376286Medicare PIN
OR175066Medicare PIN