Provider Demographics
NPI:1417994047
Name:O'BRIEN, CATHERINE ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:ANNE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:875 OAK ST SE
Mailing Address - Street 2:SUITE 4030
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3975
Mailing Address - Country:US
Mailing Address - Phone:503-561-6449
Mailing Address - Fax:503-561-6442
Practice Address - Street 1:2700 SE STRATUS AVE.
Practice Address - Street 2:SUITE A
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128
Practice Address - Country:US
Practice Address - Phone:503-435-6590
Practice Address - Fax:503-435-6591
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD25920207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR005904Medicaid
OR005904Medicaid
ORI50181Medicare UPIN
OR107039Medicare ID - Type UnspecifiedGROUP ENTITY NUMBER