Provider Demographics
NPI:1275076168
Name:CASCADE AIDS PROJECT
Entity type:Organization
Organization Name:CASCADE AIDS PROJECT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SNR DIR COMPLIANCE & RISK MANAGEMEN
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LORAINE
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-278-3813
Mailing Address - Street 1:520 NW DAVIS ST STE 215
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3620
Mailing Address - Country:US
Mailing Address - Phone:503-278-3890
Mailing Address - Fax:
Practice Address - Street 1:2236 SE BELMONT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2817
Practice Address - Country:US
Practice Address - Phone:503-278-3890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CASCADE AIDS PROJECT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-23
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)