MEDICARE: CASCADE SCHOOL DISTRICT

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
1	251300000X	Local Education Agency (LEA)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588898803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CASCADE SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	10226 MARION RD SE
Second Line	:
City	:	TURNER
State	:	OR
Zip	:	97392-9789
Country	:	US
Telephone Number	:	503-749-8488
Fax Number	:

Provider Business Practice Location Address
First Line	:	10226 MARION RD SE
Second Line	:
City	:	TURNER
State	:	OR
Zip	:	97392-9789
Country	:	US
Telephone Number	:	503-749-8488
Fax Number	:

Authorized Official
Title or Position	:	SPECIAL SERVICES DIRECTOR
Name	:	DOUG BROTZMAN
Credential	:
Telephone Number	:	503-749-8302

Provider Enumeration Date	:	05/14/2009
Last Update Date	:	05/14/2009

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Directions to “CASCADE SCHOOL DISTRICT ” Practice Location

Language	Start Address	Practice Location

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