Provider Demographics
NPI:1063540094
Name:CASCADE WOMENS HEALTHCARE
Entity type:Organization
Organization Name:CASCADE WOMENS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:509-453-8231
Mailing Address - Street 1:3911 CASTLEVALE RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-7807
Mailing Address - Country:US
Mailing Address - Phone:509-453-8231
Mailing Address - Fax:509-453-0130
Practice Address - Street 1:3911 CASTLEVALE RD
Practice Address - Street 2:SUITE 301
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-7807
Practice Address - Country:US
Practice Address - Phone:509-453-8231
Practice Address - Fax:509-453-0130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty