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Individual

KATIE FLICKINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
200 GWEE SHUT RD, SILETZ, OR 97380-2036
(541) 444-1030
Mailing address
PO BOX 320, SILETZ, OR 97380-0320
(541) 444-1030

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
10037068
OR
163W00000X
Registered Nurse
RN182485
AZ
207Q00000X
Family Medicine Physician
247118
AZ
363LF0000X
Family Nurse Practitioner
Primary
10037068
OR
363LF0000X
Family Nurse Practitioner
247118
AZ

Other

Enumeration date
02/09/2017
Last updated
04/23/2025
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