Provider Demographics
NPI:1629023445
Name:CASCADIA FAMILY MEDICINE, LLC
Entity Type:Organization
Organization Name:CASCADIA FAMILY MEDICINE, LLC
Other - Org Name:CASCADIA FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAZPER
Authorized Official - Middle Name:E
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:ND,DC
Authorized Official - Phone:503-330-5130
Mailing Address - Street 1:620 FERNDALE DR
Mailing Address - Street 2:
Mailing Address - City:BIGFORK
Mailing Address - State:MT
Mailing Address - Zip Code:59911
Mailing Address - Country:US
Mailing Address - Phone:503-330-5130
Mailing Address - Fax:
Practice Address - Street 1:919 NW 122ND ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98177-4324
Practice Address - Country:US
Practice Address - Phone:541-797-2102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5076111N00000X
WANT 60463323175F00000X, 175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty