Provider Demographics
NPI:1659693877
Name:CASCADE NEUROSURGICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:CASCADE NEUROSURGICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:509-969-0243
Mailing Address - Street 1:100 SIEGMUND PL
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901-8200
Mailing Address - Country:US
Mailing Address - Phone:509-969-0243
Mailing Address - Fax:509-576-9780
Practice Address - Street 1:1607 CREEKSIDE LOOP
Practice Address - Street 2:SUITE 140
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-4882
Practice Address - Country:US
Practice Address - Phone:509-969-0243
Practice Address - Fax:509-576-9780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-16
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001567207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty