Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | Q1306 | TX |
N | 111NI0900X | Internist | Q1306 | TX |
Y | 207RH0002X | Hospice and Palliative Medicine | DO183076 | OR |
N | 207RH0002X | Hospice and Palliative Medicine | Q1306 | TX |
N | 207RH0003X | Hematology & Oncology | DO183076 | OR |
NPI | 1114241775 |
---|---|
Provider Name | Katie Heintz Stowers |
First Address | Portland, OR 97239-3011 |
Second Address | Portland, OR 97239-3011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2010 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
338510601 | (05) | TX |
DO183076 | STATE MEDICAL LICENSE (01) | OR |