Provider Demographics
NPI:1144904533
Name:HITE-GODECK, CATHLEEN E
Entity type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:E
Last Name:HITE-GODECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHLEEN
Other - Middle Name:E
Other - Last Name:GODECK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8459
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97207-8459
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1035 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:OR
Practice Address - Zip Code:97027-2154
Practice Address - Country:US
Practice Address - Phone:503-722-3877
Practice Address - Fax:503-387-5653
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant