Provider Demographics
NPI:1447600796
Name:CASCADE HOSPICE & PALLIATIVE CARE CONSULTING, INC
Entity Type:Organization
Organization Name:CASCADE HOSPICE & PALLIATIVE CARE CONSULTING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:PATRIZIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-705-7505
Mailing Address - Street 1:4355 W RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-7734
Mailing Address - Country:US
Mailing Address - Phone:541-705-7505
Mailing Address - Fax:541-244-9050
Practice Address - Street 1:4355 W RIDGE DR
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-7734
Practice Address - Country:US
Practice Address - Phone:541-705-7505
Practice Address - Fax:541-244-9050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD24391207QH0002X
WAMD60191672207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR227266Medicaid
OR227266Medicaid
OR116335Medicare PIN