Healthcare Provider Details

I. General information

NPI: 1417994047
Provider Name (Legal Business Name): CATHERINE ANNE O'BRIEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/08/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 SE STRATUS AVE. SUITE A
MCMINNVILLE OR
97128
US

IV. Provider business mailing address

875 OAK ST SE SUITE 4030
SALEM OR
97301-3975
US

V. Phone/Fax

Practice location:
  • Phone: 503-435-6590
  • Fax: 503-435-6591
Mailing address:
  • Phone: 503-561-6449
  • Fax: 503-561-6442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD25920
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: