Healthcare Provider Details

I. General information

NPI: 1215006606
Provider Name (Legal Business Name): CASCADIA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/25/2022
Certification Date: 07/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

959 NE 165TH AVE
PORTLAND OR
97230-6148
US

IV. Provider business mailing address

PO BOX 8459
PORTLAND OR
97207-8459
US

V. Phone/Fax

Practice location:
  • Phone: 503-408-8100
  • Fax: 503-408-8384
Mailing address:
  • Phone: 503-238-0769
  • Fax: 503-552-6208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HEATHER J MCALPINE
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 503-238-0769