Provider Demographics
NPI:1548837859
Name:MARTIN, CATHERINE DAWN (PSS, CRM)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:DAWN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PSS, CRM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 SW WESTVALE ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-7123
Mailing Address - Country:US
Mailing Address - Phone:541-306-7587
Mailing Address - Fax:
Practice Address - Street 1:535 SW WESTVALE ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-7123
Practice Address - Country:US
Practice Address - Phone:541-306-7587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-06
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer Specialist
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty