Provider Demographics
NPI:1710673124
Name:CASCADE EYE CENTER LLC
Entity Type:Organization
Organization Name:CASCADE EYE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:541-296-1101
Mailing Address - Street 1:301 CHERRY HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-3586
Mailing Address - Country:US
Mailing Address - Phone:541-296-1101
Mailing Address - Fax:541-298-1538
Practice Address - Street 1:2025 CASCADE AVE STE 101
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1272
Practice Address - Country:US
Practice Address - Phone:541-386-2402
Practice Address - Fax:541-308-0293
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CASCADE EYE CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier