Provider Demographics
NPI:1649261223
Name:CATHEY, MICHELE MARIE (FNP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:MARIE
Last Name:CATHEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11376 SE LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-2749
Mailing Address - Country:US
Mailing Address - Phone:503-866-3738
Mailing Address - Fax:
Practice Address - Street 1:333 1ST ST STE A
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-2661
Practice Address - Country:US
Practice Address - Phone:888-803-3370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR97006277363LF0000X
OR097006277N1363LF0000X
CA95020407363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR273828Medicaid
OR097006277N1OtherNURSE PRACTITIONER STATE LICENSE
CANP95020407OtherNURSE PRACTITIONER LICENSE
138156Medicare PIN