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General NPI Number Information
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NPI Number | 1871380188
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Entity Type | Organization
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Legal Business Name | CASCADIA CLUBHOUSE
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 30232 44TH AVE NW
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City | STANWOOD
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State | WA
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Zip | 98292-9605
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Country | US
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Telephone | 360-928-5884
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 886
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City | SEDRO WOOLLEY
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State | WA
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Zip | 98284-0036
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Country | US
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Telephone | 360-928-5884
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SEANNA LYNN HERRING-JENSEN
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Credential |
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Telephone | 360-928-5884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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