Individual
KATHERINE ANNE LIEBLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1321 NE 99TH AVE, SUITE 200, PORTLAND, OR 97220-9439
(503) 215-4250
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA160584
OR
363A00000X
Physician Assistant
PA18752
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500623080
—
OR
Enumeration date
02/21/2007
Last updated
10/13/2021
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