Provider Demographics
NPI:1003217761
Name:CASCADIA HEALTH
Entity Type:Organization
Organization Name:CASCADIA HEALTH
Other - Org Name:CASCADIA BEHAVIORAL HEALTHCARE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCALPINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-238-0769
Mailing Address - Street 1:PO BOX 8459
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97207-8459
Mailing Address - Country:US
Mailing Address - Phone:503-238-0769
Mailing Address - Fax:503-963-7711
Practice Address - Street 1:9125 SW 55TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-5018
Practice Address - Country:US
Practice Address - Phone:503-238-0769
Practice Address - Fax:503-477-4598
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CASCADIA HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-11
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500680333Medicaid