Provider Demographics
NPI:1790450641
Name:CASCADE NURSE DELEGATING LLC
Entity Type:Organization
Organization Name:CASCADE NURSE DELEGATING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BINTOU
Authorized Official - Middle Name:
Authorized Official - Last Name:SANNEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-808-4390
Mailing Address - Street 1:2914 84TH DR NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-6891
Mailing Address - Country:US
Mailing Address - Phone:816-808-4390
Mailing Address - Fax:
Practice Address - Street 1:2914 84TH DR NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-6891
Practice Address - Country:US
Practice Address - Phone:816-808-4390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2181709Medicaid