CASCADE WEST MEDICAL PRACTICE LLC NPI 1639468432

NPI Information

CASCADE WEST MEDICAL PRACTICE LLC is an adult health nurse practitioner in Grants Pass, OR. CASCADE WEST MEDICAL PRACTICE LLC NPI is 1639468432. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Cascade West Primary Care Clinic.

The provider's business location address is:

201 NE SAVAGE ST
GRANTS PASS, OR
ZIP 97526-309
Phone: (541) 787-4360
Fax: (360) 216-7677

The provider's authorized official is Michael L Johnson .
The authorized official title is Office Manager and has the following contact phone number (541) 450-8345.

The CLIA number assigned to this NPI record is 38D2025934 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/1/2011 and was last updated on 4/1/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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