Provider Demographics
NPI:1841008224
Name:MARCELO, CATHERINA MACANDOG (HOME CARE AIDE)
Entity type:Individual
Prefix:MRS
First Name:CATHERINA
Middle Name:MACANDOG
Last Name:MARCELO
Suffix:
Gender:F
Credentials:HOME CARE AIDE
Other - Prefix:MS
Other - First Name:CATHY
Other - Middle Name:M
Other - Last Name:MARCELO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HOME CARE AIDE
Mailing Address - Street 1:5731 SOUND AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-1262
Mailing Address - Country:US
Mailing Address - Phone:206-321-5930
Mailing Address - Fax:
Practice Address - Street 1:104 N 177TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-4707
Practice Address - Country:US
Practice Address - Phone:206-321-5930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHM60516386374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide