Provider Demographics
NPI:1376758003
Name:CATABAY, MELAINA DEL (ABO)
Entity Type:Individual
Prefix:
First Name:MELAINA
Middle Name:DEL
Last Name:CATABAY
Suffix:
Gender:F
Credentials:ABO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 SE BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-4244
Mailing Address - Country:US
Mailing Address - Phone:503-335-7173
Mailing Address - Fax:503-335-7973
Practice Address - Street 1:3333 SE BELMONT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-4244
Practice Address - Country:US
Practice Address - Phone:503-335-7173
Practice Address - Fax:503-335-7973
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADO00001608156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician