Provider Demographics
NPI:1861681967
Name:KATHERINE MECHLING
Entity Type:Organization
Organization Name:KATHERINE MECHLING
Other - Org Name:CLEAR CREEK FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MECHLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-597-2464
Mailing Address - Street 1:PO BOX 847
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:OR
Mailing Address - Zip Code:97538-0847
Mailing Address - Country:US
Mailing Address - Phone:541-597-2464
Mailing Address - Fax:541-597-4280
Practice Address - Street 1:18173 REDWOOD HWY
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:OR
Practice Address - Zip Code:97538-0847
Practice Address - Country:US
Practice Address - Phone:541-597-2464
Practice Address - Fax:541-597-4280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD19485261QF0050X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical