Individual
KATIE MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17720 NE HALSEY ST STE A, PORTLAND, OR 97230-6771
(503) 654-7654
(503) 654-7333
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
PROFESSIONALLICENSE
—
Other
Enumeration date
07/05/2019
Last updated
02/08/2022
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