Provider Demographics
NPI:1427247279
Name:MENDEZ, CASIE DAWN
Entity type:Individual
Prefix:MRS
First Name:CASIE
Middle Name:DAWN
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CASIE
Other - Middle Name:DAWN
Other - Last Name:HUME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1137 25TH ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-1604
Mailing Address - Country:US
Mailing Address - Phone:503-362-1399
Mailing Address - Fax:
Practice Address - Street 1:1137 25TH ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-1604
Practice Address - Country:US
Practice Address - Phone:503-362-1399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator