Provider Demographics
NPI:1649836586
Name:MCLEAN, KATHRYN BODE
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:BODE
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 ADAMS LOOP
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-9743
Mailing Address - Country:US
Mailing Address - Phone:541-308-6580
Mailing Address - Fax:
Practice Address - Street 1:804 ADAMS LOOP
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-9743
Practice Address - Country:US
Practice Address - Phone:541-308-6580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula