Provider Demographics
NPI:1215985502
Name:CASCADE SURGERY ASSOCIATES, PLLC
Entity type:Organization
Organization Name:CASCADE SURGERY ASSOCIATES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHISH
Authorized Official - Middle Name:M
Authorized Official - Last Name:TRIVEDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-333-1637
Mailing Address - Street 1:PO BOX 35142 #698909
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-5142
Mailing Address - Country:US
Mailing Address - Phone:253-333-6960
Mailing Address - Fax:
Practice Address - Street 1:125 3RD ST NE STE 402
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4035
Practice Address - Country:US
Practice Address - Phone:253-333-1637
Practice Address - Fax:253-351-8509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7066277Medicaid
WA8917098OtherL&I GROUP
WACN8221OtherRAIRLROAD MEDICARE
WACG6198OtherRAILROAD MEDICARE
WACG6198OtherRAILROAD MEDICARE