Individual
KATHERINE C BALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3181 SW SAM JACKSON PARK RD # DCH9N, PORTLAND, OR 97239-3011
(713) 412-8285
Mailing address
3833 S BOND AVE APT 412, PORTLAND, OR 97239-4740
(713) 412-8285
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201909224RN
OR
363LP0200X
Pediatric Nurse Practitioner
Primary
10004790
OR
Other
Enumeration date
09/15/2021
Last updated
06/28/2023
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