Provider Demographics
NPI:1578672382
Name:TERRY L. STECKMAN, O.D.,P.C.
Entity Type:Organization
Organization Name:TERRY L. STECKMAN, O.D.,P.C.
Other - Org Name:CASCADE EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STECKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-382-2020
Mailing Address - Street 1:62968 O B RILEY RD
Mailing Address - Street 2:STE #11
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-9442
Mailing Address - Country:US
Mailing Address - Phone:541-382-2020
Mailing Address - Fax:541-382-5004
Practice Address - Street 1:62968 O B RILEY RD
Practice Address - Street 2:STE#11
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-9442
Practice Address - Country:US
Practice Address - Phone:541-382-2020
Practice Address - Fax:541-382-5004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1407ATI152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR233015Medicaid
OR233015Medicaid
ORR113447Medicare PIN
OR4495960001Medicare NSC