Provider Demographics
NPI:1508820556
Name:CASCADE FAMILY MEDICAL GROUP, P.S.
Entity Type:Organization
Organization Name:CASCADE FAMILY MEDICAL GROUP, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-435-2144
Mailing Address - Street 1:326 S STILLAGUAMISH AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-1652
Mailing Address - Country:US
Mailing Address - Phone:360-435-2144
Mailing Address - Fax:360-435-9601
Practice Address - Street 1:326 S STILLAGUAMISH AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1652
Practice Address - Country:US
Practice Address - Phone:360-435-2144
Practice Address - Fax:360-435-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0080350OtherLABOR & INDUSTRIES
WA7040884Medicaid