Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | M4727 | TX |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 164925 | OR |
NPI | 1134212202 |
---|---|
Provider Name | Melinda Augustine Caskey |
First Address | Clackamas, OR 97015-8970 |
Second Address | Clackamas, OR 97015-8970 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 04/02/2022 |