Waldorf, Kathleen Anne
Waldorf, Kathleen Anne is an sole proprietor health care provider with primary practice located at 9775 Sw Wilshire St Suite 200, Portland OR 97225. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Plastic Surgery. Allopathic & Osteopathic Physicians / Plastic Surgery is her primary health care specialty. Waldorf, Kathleen Anne can be contacted via phone (503) 646-0101.Contact Information
Primary practice address
9775 Sw Wilshire St Suite 200
Portland OR 97225
Phone: (503) 646-0101
Fax: (503) 350-1420
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | MD16987 | Oregon |
| Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | MD16987 | Oregon |
Profile Details
| NPI number | 1902995194 |
|---|---|
| LBN Legal business name | Waldorf, Kathleen Anne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 12th, 2006 |
| Last updated | Mar 12th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902995194 | NPPES |
| Oregon | Other | 93-111-8189 | TAX IDENTIFICATION |
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