Provider Demographics
NPI:1609465111
Name:CASCADE NORTHWEST SERVICES LLC
Entity Type:Organization
Organization Name:CASCADE NORTHWEST SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:R
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:360-322-7626
Mailing Address - Street 1:17306 SMOKEY POINT DR STE 21
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-4707
Mailing Address - Country:US
Mailing Address - Phone:360-322-7626
Mailing Address - Fax:
Practice Address - Street 1:17306 SMOKEY POINT DR STE 21
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-4707
Practice Address - Country:US
Practice Address - Phone:360-322-7626
Practice Address - Fax:360-925-3479
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CASCADE NORTHWEST SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory