Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | MD165666 | OR |
NPI | 1023378429 |
---|---|
Provider Name | Katherine Lopez Sankey |
First Address | Happy Valley, OR 97086-4257 |
Second Address | Milwaukie, OR 97222-6594 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2012 |
Last Update Date | 18/04/2016 |