Healthcare Provider Details

I. General information

NPI: 1700182425
Provider Name (Legal Business Name): CASCADE HOSPICE & PALLIATIVE CARE CONSULTING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2011
Last Update Date: 04/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4355 W RIDGE DR
HOOD RIVER OR
97031-7734
US

IV. Provider business mailing address

4355 W RIDGE DR
HOOD RIVER OR
97031-7734
US

V. Phone/Fax

Practice location:
  • Phone: 541-705-7505
  • Fax: 971-244-9050
Mailing address:
  • Phone: 541-705-7505
  • Fax: 971-244-9050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberMD60191672
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberMD24391
License Number StateOR

VIII. Authorized Official

Name: DR. GLEN R PATRIZIO
Title or Position: PRESIDENT & MEDICAL DIRECTOR
Credential: MD
Phone: 541-705-7505