Provider Demographics
NPI:1952048837
Name:CASCADE COAST NATURAL HEALTH
Entity Type:Organization
Organization Name:CASCADE COAST NATURAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-395-2500
Mailing Address - Street 1:7738 SW 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-2420
Mailing Address - Country:US
Mailing Address - Phone:503-395-2500
Mailing Address - Fax:844-811-6370
Practice Address - Street 1:1340 SW BERTHA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-2172
Practice Address - Country:US
Practice Address - Phone:503-395-2500
Practice Address - Fax:844-811-6370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care