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CAITLIN HODGES DEDEAUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
3303 SW BOND AVE, PORTLAND, OR 97239-4501
(503) 494-7737
Mailing address
245 SW LINCOLN ST APT 5532, PORTLAND, OR 97201-5052
(225) 247-1375

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
PA172323
OR
363A00000X
Physician Assistant
PA.200756
LA

Other

Enumeration date
09/18/2014
Last updated
10/30/2015
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