Healthcare Provider Details

I. General information

NPI: 1609187681
Provider Name (Legal Business Name): CAITLIN K MCCARTHY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAITLIN K GADE M.D.

II. Dates (important events)

Enumeration Date: 06/24/2010
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 E 19TH ST SUITE 225
THE DALLES OR
97058-3388
US

IV. Provider business mailing address

1810 E 19TH ST SUITE 225
THE DALLES OR
97058-3388
US

V. Phone/Fax

Practice location:
  • Phone: 541-296-6101
  • Fax: 541-296-0025
Mailing address:
  • Phone: 541-296-6101
  • Fax: 541-296-0025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD170815
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: