Provider Demographics
NPI:1578803037
Name:CASCADE ACUPUNCTURE CENTER, LLC
Entity Type:Organization
Organization Name:CASCADE ACUPUNCTURE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANI
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWSE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:541-387-4325
Mailing Address - Street 1:PO BOX 556
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-0018
Mailing Address - Country:US
Mailing Address - Phone:509-637-3163
Mailing Address - Fax:541-387-4326
Practice Address - Street 1:40 SW CASCADE AVE.
Practice Address - Street 2:STE. 40
Practice Address - City:STEVENSON
Practice Address - State:WA
Practice Address - Zip Code:98648
Practice Address - Country:US
Practice Address - Phone:509-637-3163
Practice Address - Fax:541-387-4326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-21
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002120171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty