Provider Demographics
NPI:1598893729
Name:CASCADIA BEHAVIOR HEALTH
Entity Type:Organization
Organization Name:CASCADIA BEHAVIOR HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENTIAL COUNSEL
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDWINA
Authorized Official - Middle Name:LYNNEICE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-249-7767
Mailing Address - Street 1:6207 NE 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-4805
Mailing Address - Country:US
Mailing Address - Phone:503-493-9498
Mailing Address - Fax:503-493-9497
Practice Address - Street 1:509 NE ALBERTA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-3976
Practice Address - Country:US
Practice Address - Phone:503-249-7767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness