Provider Demographics
NPI:1699767103
Name:MECHLING, KATHERINE (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:MECHLING
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 1:18173 REDWOOD HWY
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:OR
Mailing Address - Zip Code:97538-9732
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:97538-9732
Practice Address - Country:US
Practice Address - Phone:541-597-2464
Practice Address - Fax:541-597-4280
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD19485207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR077185Medicaid
ORR107364Medicare PIN
OR077185Medicaid