Provider Demographics
NPI:1205927134
Name:MACCABEE, MENDY (MD)
Entity type:Individual
Prefix:DR
First Name:MENDY
Middle Name:
Last Name:MACCABEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1784 MAY ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1353
Mailing Address - Country:US
Mailing Address - Phone:541-436-3880
Mailing Address - Fax:541-436-3881
Practice Address - Street 1:1784 MAY ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1353
Practice Address - Country:US
Practice Address - Phone:541-436-3880
Practice Address - Fax:541-436-3881
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD177898207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB207418OtherMEDICARE ID
CAFV578ZMedicare PIN
C53844OtherCA MD LICENSE