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NPI Code Detail

MEDICARE: DR. CORY JACOB CASCALHEIRA PHD

MEDICARE: DR. CORY JACOB CASCALHEIRA PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling PsychologistPSYC.PY.61612304WA

General Provider Information

NPI Number : 1417783051
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CORY JACOB CASCALHEIRA PHD
Provider Business Mailing Address
First Line : 1660 S COLUMBIAN WAY
Second Line : CASCALHEIRA, S-166-DDTP
City : SEATTLE
State : WA
Zip : 98108-1532
Country : US
Telephone Number : 206-277-3600
Fax Number :
Provider Business Practice Location Address
First Line : 1660 S COLUMBIAN WAY
Second Line : ADDICTION TREATMENT CENTER
City : SEATTLE
State : WA
Zip : 98108-1532
Country : US
Telephone Number : 206-277-4592
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2024
Last Update Date : 02/19/2026

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