Healthcare Provider Details

I. General information

NPI: 1356307508
Provider Name (Legal Business Name): CASCADE SURGERY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 05/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27121 174TH PL SE SUITE 204
COVINGTON WA
98042-4939
US

IV. Provider business mailing address

122 3RD ST NE
AUBURN WA
98002-4013
US

V. Phone/Fax

Practice location:
  • Phone: 253-638-8642
  • Fax: 253-638-8647
Mailing address:
  • Phone: 253-833-7750
  • Fax: 253-833-7469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: SANDRA L. TAYLOR
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 253-876-7030