Provider Demographics
NPI:1356307508
Name:CASCADE SURGERY ASSOCIATES
Entity Type:Organization
Organization Name:CASCADE SURGERY ASSOCIATES
Other - Org Name:CASCADE ORTHOPAEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-876-7030
Mailing Address - Street 1:122 3RD ST NE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4013
Mailing Address - Country:US
Mailing Address - Phone:253-833-7750
Mailing Address - Fax:253-833-7469
Practice Address - Street 1:27121 174TH PL SE
Practice Address - Street 2:SUITE 204
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-4939
Practice Address - Country:US
Practice Address - Phone:253-638-8642
Practice Address - Fax:253-638-8647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA75850OtherL&I GRP
WA7066277Medicaid
WA7066277Medicaid