Provider Demographics
NPI:1942021175
Name:COETZEE, CASSANDRA NICOLE (MBBS)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:NICOLE
Last Name:COETZEE
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:NICOLE
Other - Last Name:FARMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:SHRINERS HOSPITALS FOR CHILDREN PORTLAND
Mailing Address - Street 2:3101 SW SAM JACKSON PARK ROAD
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3009
Mailing Address - Country:US
Mailing Address - Phone:503-221-4324
Mailing Address - Fax:503-221-3490
Practice Address - Street 1:SHRINERS HOSPITALS FOR CHILDREN PORTLAND
Practice Address - Street 2:3101 SW SAM JACKSON PARK ROAD
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3009
Practice Address - Country:US
Practice Address - Phone:503-221-4324
Practice Address - Fax:503-221-3490
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program