Provider Demographics
NPI:1588629208
Name:MCCAFFREY, KATE (DO)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:MCCAFFREY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SWEET HOME
Mailing Address - State:OR
Mailing Address - Zip Code:97386-3305
Mailing Address - Country:US
Mailing Address - Phone:541-451-6250
Mailing Address - Fax:
Practice Address - Street 1:679 MAIN ST
Practice Address - Street 2:
Practice Address - City:SWEET HOME
Practice Address - State:OR
Practice Address - Zip Code:97386-3305
Practice Address - Country:US
Practice Address - Phone:541-451-6250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA208316204D00000X
CA20 A8316207Q00000X
ORDO159587204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine