Provider Demographics
NPI:1982672184
Name:CASCADE PHYSICIANS, P.C.
Entity Type:Organization
Organization Name:CASCADE PHYSICIANS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:B
Authorized Official - Last Name:KEARSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-242-9850
Mailing Address - Street 1:PO BOX 86309
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97286-0309
Mailing Address - Country:US
Mailing Address - Phone:503-242-9850
Mailing Address - Fax:503-226-5353
Practice Address - Street 1:2222 NW LOVEJOY ST
Practice Address - Street 2:STE 505
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-5103
Practice Address - Country:US
Practice Address - Phone:503-242-9850
Practice Address - Fax:503-249-5788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR0000WFBKQMedicare PIN
ORR0000WCTBBMedicare PIN
ORR0000WFBDCMedicare PIN
ORR0000WCZBLMedicare PIN