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General NPI Number Information
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NPI Number | 1851596001
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Entity Type | Organization
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Legal Business Name | CASCADE PATHWAYS, LLC
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 09/29/2015
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Provider Practice Location Address
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Address Line | 344 NW 6TH ST
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City | CORVALLIS
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State | OR
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Zip | 97330-4814
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Country | US
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Telephone | 541-954-7077
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Fax | 888-505-1903
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Provider Business Mailing Address
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Address Line | 344 NW 6TH ST
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City | CORVALLIS
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State | OR
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Zip | 97330-4814
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Country | US
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Telephone | 541-954-7077
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Fax | 888-505-1903
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. HAL CLIFFORD DARST
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Credential | CADCII
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Telephone | 541-954-7077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 99-11-61
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License Number State | OR
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