Healthcare Provider Details

I. General information

NPI: 1437280120
Provider Name (Legal Business Name): CASCASDE OCCUPATIONAL MEDICINE PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 KRUSE WAY PL BUILDING 2, SUITE 160
LAKE OSWEGO OR
97035-5545
US

IV. Provider business mailing address

PO BOX 1548
LAKE OSWEGO OR
97035-0748
US

V. Phone/Fax

Practice location:
  • Phone: 503-635-1960
  • Fax: 503-635-8354
Mailing address:
  • Phone: 503-635-1960
  • Fax: 503-635-8354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN ROGERS BRADDOCK
Title or Position: CEO MEDICAL DIRECTOR
Credential: M.D.
Phone: 503-635-1960