Individual
KATHARYN BRANDI LACRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDPSW BHPCA CHW
Contact information
Practice address
70 SW CENTURY DR STE 100-1079, BEND, OR 97702-3557
(541) 977-7078
Mailing address
70 SW CENTURY DR STE 100-1079, BEND, OR 97702-3557
(541) 977-7078
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
OR
133N00000X
Nutritionist
—
—
171000000X
Military Health Care Provider
—
—
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
OR
1744R1102X
Research Study Specialist
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
175F00000X
Naturopath
—
OR
176B00000X
Midwife
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
NA
OR
246Z00000X
Other Specialist/Technologist
—
—
374J00000X
Doula
THW000110802
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
864218
PCA-PDC (OHCC) PERSONAL CARE PROFESSIONAL CERTIFIED
OR
01
—
865890
IDD-PSW OREGON STATE PLAN PERSONAL CARE SERVICES (SPPC/84-800) OHA
OR
01
—
868421
HCW-PDC HOME CARE PROFESSIONAL CERTIFIED (OHCC)
OR
01
—
COS-FT-10184774
AESTHETICIAN (OHA-BOARD OF COSMETOLOGY)
OR
01
—
NA
PWS-PEER WELLNESS SPECIALIST (OHA)
OR
01
—
NA
PCD-POSTPARTUM DOULA (SIMKIN CENTER FOR ALLIED BIRTH VOCATIONS)
—
01
—
T-24-4235
CADC-R CERTIFIED ALCOHOL AND DRUG COUNSELOR (MHACBO)
OR
01
—
THW000110802
THW-TRADITIONAL HEALTH WORKER (OHA)
OR
Enumeration date
06/12/2024
Last updated
08/19/2024
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