Provider Demographics
NPI:1689113649
Name:HAESE, KAITLYN (DC, MS)
Entity type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:
Last Name:HAESE
Suffix:
Gender:F
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 WILLAMETTE ST # 301-308
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4014
Mailing Address - Country:US
Mailing Address - Phone:541-512-4990
Mailing Address - Fax:541-897-9960
Practice Address - Street 1:260 E 15TH AVE STE D
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4177
Practice Address - Country:US
Practice Address - Phone:541-512-4990
Practice Address - Fax:541-897-9960
Is Sole Proprietor?:No
Enumeration Date:2017-02-22
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5786111NP0017X, 111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician