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NPI Code Detail

MEDICARE: CASCADE MEDICAL IMAGING LLC

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
12085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1760253975
Entity Type Code : Organization
Provider Name (Legal Business Name) : CASCADE MEDICAL IMAGING LLC
Provider Business Mailing Address
First Line : PO BOX 6085
Second Line :
City : BEND
State : OR
Zip : 97708-6085
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 : 541-388-0673
Fax Number :
Authorized Official
Title or Position : ASSOCIATE ADMINISTRATOR
Name : KRISTINE ANNE HARVEY
Credential :
Telephone Number : 541-598-3218
Provider Enumeration Date : 01/16/2024
Last Update Date : 01/16/2024

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Directions to “CASCADE MEDICAL IMAGING LLC ” Practice Location

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