Katheryn Nuckolls, N.D.

Primary specialty

NaturopathTaxonomy code 175F00000X

License

4086 Issued in OR

Practice address

650 SW 3Rd St
Corvallis, OR 97333

Phone

(541) 602-0260

Fax

(541) 753-4217

NPI assigned

Apr 16, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1811317928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 NE 86TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986622109",
            "telephone_number": "602-359-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 SW 3RD ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "97333",
            "telephone_number": "541-602-0260",
            "fax_number": "541-753-4217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9901 NE 86th St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986622109",
            "country_code": "US",
            "telephone_number": "602-359-2893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUCKOLLS",
        "first_name": "KATHERYN",
        "credential": "N.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-16",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "AZ",
            "license": "14-1424",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "WA",
            "license": "61288239",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "4086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Naturopath in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Naturopath in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.