Provider Demographics
NPI:1194399899
Name:CPM MEDICINE LLC
Entity Type:Organization
Organization Name:CPM MEDICINE LLC
Other - Org Name:CASCADE PSYCHEDELIC MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-453-2941
Mailing Address - Street 1:2743 NE 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-3202
Mailing Address - Country:US
Mailing Address - Phone:503-453-2941
Mailing Address - Fax:
Practice Address - Street 1:2027 NE FLANDERS ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-3372
Practice Address - Country:US
Practice Address - Phone:503-453-2941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-17
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty