Provider Demographics
NPI:1619763612
Name:GORMAN, KATIE MARIE (NRP)
Entity type:Individual
Prefix:MISS
First Name:KATIE
Middle Name:MARIE
Last Name:GORMAN
Suffix:
Gender:
Credentials:NRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 SE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-4431
Mailing Address - Country:US
Mailing Address - Phone:406-402-4755
Mailing Address - Fax:
Practice Address - Street 1:2801 NE 22ND ST
Practice Address - Street 2:
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-4221
Practice Address - Country:US
Practice Address - Phone:541-994-6690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-PARA-LIC-49774146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic