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NPI Code Detail

MEDICARE: CASCADE FAMILY MEDICAL GROUP, P.S.

MEDICARE: CASCADE FAMILY MEDICAL GROUP, P.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/CenterWA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10080350OTHERWALABOR & INDUSTRIES
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508820556
Entity Type Code : Organization
Provider Name (Legal Business Name) : CASCADE FAMILY MEDICAL GROUP, P.S.
Provider Business Mailing Address
First Line : 326 S STILLAGUAMISH AVE
Second Line :
City : ARLINGTON
State : WA
Zip : 98223-1652
Country : US
Telephone Number : 360-435-2144
Fax Number : 360-435-9601
Provider Business Practice Location Address
First Line : 326 S STILLAGUAMISH AVE
Second Line :
City : ARLINGTON
State : WA
Zip : 98223-1652
Country : US
Telephone Number : 360-435-2144
Fax Number : 360-435-9601
Authorized Official
Title or Position : OWNER/PHYSICIAN
Name : MARK E SPENCER
Credential : M.D.
Telephone Number : 360-435-2144
Provider Enumeration Date : 04/14/2006
Last Update Date : 08/22/2020

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