Provider Demographics
NPI:1073659744
Name:CASCADIA BEHAVIORAL HEALTHCARE
Entity Type:Organization
Organization Name:CASCADIA BEHAVIORAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT COUNCELOR 1
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARUNDAH
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:VARIES
Authorized Official - Phone:503-788-3187
Mailing Address - Street 1:2322 SE 89TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2016
Mailing Address - Country:US
Mailing Address - Phone:503-788-3187
Mailing Address - Fax:
Practice Address - Street 1:945 NE 165TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-6148
Practice Address - Country:US
Practice Address - Phone:503-408-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness