Individual
MS. KATHERINE MARIE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3325 POCAHONTAS RD, BAKER CITY, OR 97814-1464
(541) 524-8000
(541) 524-7955
Mailing address
3340 E GOLDSTONE DR, MERIDIAN, ID 83642-1026
(208) 302-9342
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA169484
OR
Other
Enumeration date
10/05/2014
Last updated
03/23/2023
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