Provider Demographics
NPI:1114561156
Name:CASCADE HEALTH CLINIC LLC
Entity Type:Organization
Organization Name:CASCADE HEALTH CLINIC LLC
Other - Org Name:CASCADE HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:F
Authorized Official - Last Name:CASSIDY
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:360-793-3883
Mailing Address - Street 1:PO BOX 1696
Mailing Address - Street 2:
Mailing Address - City:SULTAN
Mailing Address - State:WA
Mailing Address - Zip Code:98294-1696
Mailing Address - Country:US
Mailing Address - Phone:360-793-3883
Mailing Address - Fax:360-793-2921
Practice Address - Street 1:307 MAIN ST
Practice Address - Street 2:
Practice Address - City:SULTAN
Practice Address - State:WA
Practice Address - Zip Code:98294-0197
Practice Address - Country:US
Practice Address - Phone:360-793-3883
Practice Address - Fax:360-793-2921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-02
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA20161012330984Medicaid