Provider Demographics
NPI:1295138170
Name:LEWIS, KATHERINE JEAN (ND)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:JEAN
Last Name:LEWIS
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 1:5050 SW LANDING DR APT 101
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-5968
Mailing Address - Country:US
Mailing Address - Phone:503-407-9551
Mailing Address - Fax:
Practice Address - Street 1:5050 SW LANDING DR APT 101
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-5968
Practice Address - Country:US
Practice Address - Phone:503-407-9551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2037175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath