Provider Demographics
NPI:1063141919
Name:CASCADE ORTHOPEDIC SPECIALISTS LLC
Entity type:Organization
Organization Name:CASCADE ORTHOPEDIC SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NORA
Authorized Official - Middle Name:CARLENE
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-391-8155
Mailing Address - Street 1:1813 W HARVARD AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-2753
Mailing Address - Country:US
Mailing Address - Phone:541-391-8155
Mailing Address - Fax:541-391-8154
Practice Address - Street 1:1813 W HARVARD AVE STE 110
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-2753
Practice Address - Country:US
Practice Address - Phone:541-391-8155
Practice Address - Fax:541-391-8154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty