Healthcare Provider Details

I. General information

NPI: 1659337889
Provider Name (Legal Business Name): CASCADE SURGERY ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 AUBURN AVE STE 200
AUBURN WA
98002-5082
US

IV. Provider business mailing address

PO BOX 35142 #698909
SEATTLE WA
98124-5142
US

V. Phone/Fax

Practice location:
  • Phone: 253-288-2140
  • Fax:
Mailing address:
  • Phone: 253-288-2140
  • Fax: 253-288-2219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateWA

VIII. Authorized Official

Name: SHAUN SCHULLER
Title or Position: PRACTICE MANAGER
Credential:
Phone: 253-833-7750