Provider Demographics
NPI:1326747361
Name:CASCADE EYE CENTER LLC
Entity Type:Organization
Organization Name:CASCADE EYE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:541-296-1101
Mailing Address - Street 1:301 CHERRY HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-3586
Mailing Address - Country:US
Mailing Address - Phone:541-296-1101
Mailing Address - Fax:541-298-1538
Practice Address - Street 1:301 CHERRY HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-3586
Practice Address - Country:US
Practice Address - Phone:541-296-1101
Practice Address - Fax:541-298-1538
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CASCADE EYE CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier