Provider Demographics
NPI:1467635193
Name:CASCADE SURGICCAL ONCOLOGY, PC
Entity Type:Organization
Organization Name:CASCADE SURGICCAL ONCOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:TREZONA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-302-6469
Mailing Address - Street 1:1200 HILYARD ST STE S550
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-8152
Mailing Address - Country:US
Mailing Address - Phone:541-302-6469
Mailing Address - Fax:541-302-6473
Practice Address - Street 1:1200 HILYARD ST STE S550
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8152
Practice Address - Country:US
Practice Address - Phone:541-302-6469
Practice Address - Fax:541-302-6473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5659440001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR801750000OtherBLUE CROSS
OR240426Medicaid
OR801750000OtherBLUE CROSS