Individual provider Active NPI

Christine M. Katterhagen, M.D.

  • Surgery Physician
  • Longview, WA
National Provider Identifier
1477551646
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD00034927 Issued in WA
Practice address
1615 Delaware St
Longview, WA 98632-2310
Phone
(360) 501-3500
Fax
(360) 501-3555
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD00034927 WA Primary

Addresses

Primary practice location

1615 Delaware St
Longview, WA 98632-2310

Mailing address

PO Box 3002
Longview, WA 98632-0302
Phone (360) 501-3500

Other identifiers 5

IdentifierTypeStateIssuer
150235MedicaidOR
8208043MedicaidWA
P00381729OtherRR MEDICARE
8943477OtherWACRIME VICTIMS
0217050OtherWALABOR & IND.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070315000343 WA Practitioner - General Surgery 0244268423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 5890689293, 188 clinicians

Practice addresses (Care Compare)

1615 Delaware St
Longview, WA 98632-2367
Phone (360) 636-4814

1660 Delware St
Longview, WA 98632-2310
Phone (360) 414-2800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Mastectomy24
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00034927WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Feb 1, 2007 Accepting new patients
Peacehealth Past Accepting new patients
Longview Surgical Group Surgery PastSince Jul 28, 2005 Accepting new patients

Locations

1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818

1615 Delaware St
Ste 200
Longview, WA 98632
Phone (360) 501-3500

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

Interoperability endpoints

  • Direct secure messaging: ckatterhagen10693@direct.peacehealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1477551646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3002",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986320302",
            "telephone_number": "360-501-3500",
            "fax_number": "360-501-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 DELAWARE ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322310",
            "telephone_number": "360-501-3500",
            "fax_number": "360-501-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATTERHAGEN",
        "first_name": "CHRISTINE",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00034927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150235",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8208043",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00381729",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8943477",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & IND.",
            "identifier": "0217050",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.