Provider Demographics
NPI:1063684835
Name:NORTH CASCADE SURGICAL, PC
Entity Type:Organization
Organization Name:NORTH CASCADE SURGICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:LOHSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-303-2451
Mailing Address - Street 1:3015 SQUALICUM PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1946
Mailing Address - Country:US
Mailing Address - Phone:360-303-2451
Mailing Address - Fax:
Practice Address - Street 1:3015 SQUALICUM PKWY STE 250
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1946
Practice Address - Country:US
Practice Address - Phone:360-303-2451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00019525174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0228956OtherL&I AND CRIME VICTIMS
WA1076009Medicaid
WA99226OtherLABOR AND INDUSTRIES
WA8328007Medicaid
WAG115116600Medicare PIN
WA0228956OtherL&I AND CRIME VICTIMS
WAAO9471Medicare UPIN