Provider Demographics
NPI:1336687987
Name:CASCADE MEDICAL ADVANTAGE
Entity Type:Organization
Organization Name:CASCADE MEDICAL ADVANTAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:AFFRON
Authorized Official - Last Name:KARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-734-2935
Mailing Address - Street 1:800 E CHESTNUT ST
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5241
Mailing Address - Country:US
Mailing Address - Phone:360-734-2935
Mailing Address - Fax:
Practice Address - Street 1:800 E CHESTNUT ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5241
Practice Address - Country:US
Practice Address - Phone:360-734-2935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00028884D207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty