Provider Demographics
NPI:1679587018
Name:CASCADE MOBILE CARE, PLLC
Entity Type:Organization
Organization Name:CASCADE MOBILE CARE, PLLC
Other - Org Name:CASCADE MOBILE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:MISIUK
Authorized Official - Suffix:
Authorized Official - Credentials:AP30006650
Authorized Official - Phone:360-738-7040
Mailing Address - Street 1:2728 ALVARADO DR
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-2306
Mailing Address - Country:US
Mailing Address - Phone:360-738-7040
Mailing Address - Fax:360-734-3146
Practice Address - Street 1:2728 ALVARADO DR
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-2306
Practice Address - Country:US
Practice Address - Phone:360-738-7040
Practice Address - Fax:360-734-3146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006650363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9643800Medicaid
WA9643800Medicaid