Provider Demographics
NPI:1659402212
Name:CASCADIA
Entity Type:Organization
Organization Name:CASCADIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENTIAL COUNSELOUR
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDESLAM
Authorized Official - Middle Name:
Authorized Official - Last Name:EL AZAOUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-980-5726
Mailing Address - Street 1:3323 SW MULTNOMAH BLVD APT 42
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-3774
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7511 SE HENRY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-6445
Practice Address - Country:US
Practice Address - Phone:503-771-6061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness