| Doctor Name: | MS. KATHLEEN GREGORY |
| NPI Number: | 1063560217 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 080044677NP |
| Business Practice Address: | 130 Nw 6th St Suite A Mcminnville, OR - 971285582 |
| Business Phone Number: | 5037754931 |
| Business Fax Number: | 5037887285 |
| Mailing Address: | 3727 Ne Martin Luther King Jr Blvd, Attn: Credentialing PORTLAND |
| State: | OR |
| Postal Code: | 972121112 |
| Phone Number: | 5037754931 |
| Fax Number: | 5037887285 |
| NPI Enumeration Date: | 01/06/2007 |
| NPI Last Update Date: | 12/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 080044677NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |