| Katie L Ketterling-thornburg, APRN, FNP-C | |
|
440 Nw Division St, Gresham, OR 97030-5506 | |
| (503) 215-9500 | |
| Not Available |
| Full Name | Katie L Ketterling-thornburg |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 6 Years |
| Location | 440 Nw Division St, Gresham, Oregon |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114489093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | NUR-APRN-LIC-145742 (Montana) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 10025675 (Oregon) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Providence Portland Medical Center | Portland, OR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Providence Health And Services Oregon | 0648183608 | 1338 |
| Entity Name | Providence Health & Services Oregon |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023488343 PECOS PAC ID: 0648183608 Enrollment ID: O20031106000652 |
| Mailing Address | Practice Location Address |
|---|---|
| Katie L Ketterling-thornburg, APRN, FNP-C Po Box 3158, Portland, OR 97208-3158 Ph: (503) 215-6494 | Katie L Ketterling-thornburg, APRN, FNP-C 440 Nw Division St, Gresham, OR 97030-5506 Ph: (503) 215-9500 |
Vivian B Vargo, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 600 Ne 8th St, Gresham, OR 97030 Phone: 503-988-5155 Fax: 503-988-5185 | |
Elana Underwood Scharff, AGACNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 25050 Se Stark St Ste 265, Gresham, OR 97030 Phone: 503-674-1520 Fax: 503-674-1599 | |
Renae Rykaczewski, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 600 Ne 8th St Ste 300, Gresham, OR 97030 Phone: 530-988-5155 | |
Alma San Juan, AGACNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 25050 Se Stark St Ste 265, Gresham, OR 97030 Phone: 503-674-1520 | |
Wendy Waibel, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 21015 Se Stark St, Gresham, OR 97030 Phone: 503-669-6120 Fax: 503-669-6163 | |
Ms. Heike K. Huchler, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2850 Se Powell Valley Rd, Gresham, OR 97080 Phone: 503-666-5050 |