MEDICARE: CASCADE MEDICAL IMAGING LLC

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
1	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1669244497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CASCADE MEDICAL IMAGING LLC

Provider Business Mailing Address
First Line	:	1460 NE MEDICAL CENTER DR
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-6061
Country	:	US
Telephone Number	:	541-382-6633
Fax Number	:	541-383-1615

Provider Business Practice Location Address
First Line	:	1693 SW CHANDLER AVE STE 120
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97702-3230
Country	:	US
Telephone Number	:	541-382-6633
Fax Number	:	541-383-1615

Authorized Official
Title or Position	:	CHIEF PHYSICIAN ADMIN SVCS OFFICER
Name	:	KRISTINE ANNE HARVEY
Credential	:
Telephone Number	:	541-598-3218

Provider Enumeration Date	:	10/25/2023
Last Update Date	:	10/25/2023

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Directions to “CASCADE MEDICAL IMAGING LLC ” Practice Location

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