Active NPI
Katherine Anne McDuffee
- Psychiatric/Mental Health Nurse Practitioner
- Tualatin, OR
National Provider Identifier
1164910725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 201802489
- Practice address
- 18840 SW Boones Ferry Rd
Tualatin, OR 97062 - Phone
- (503) 332-1251
- NPI assigned
- Apr 28, 2018
- Last updated
- Jul 22, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 201802489 | OR | Primary |
Addresses
Primary practice location
18840 SW Boones Ferry Rd
Tualatin, OR 97062
Mailing address
11009 SW Austria Loop
Wilsonville, OR 97070-2006
Phone (503) 332-1251
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 3, 2023 through Feb 3, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201802489 | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532217600000",
"number": "1164910725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11009 SW AUSTRIA LOOP",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970702006",
"telephone_number": "503-332-1251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18840 SW BOONES FERRY RD",
"city": "TUALATIN",
"state": "OR",
"postal_code": "97062",
"telephone_number": "503-332-1251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDUFFEE",
"first_name": "KATHERINE",
"middle_name": "ANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-28",
"last_updated": "2018-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "201802489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tualatin, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.