Provider Demographics
NPI:1598392599
Name:NORTHERN CASCADES FOOT AND ANKLE, LLC
Entity type:Organization
Organization Name:NORTHERN CASCADES FOOT AND ANKLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HORLEBEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:509-679-9616
Mailing Address - Street 1:PO BOX 1852
Mailing Address - Street 2:
Mailing Address - City:CHELAN
Mailing Address - State:WA
Mailing Address - Zip Code:98816-1852
Mailing Address - Country:US
Mailing Address - Phone:509-679-1415
Mailing Address - Fax:
Practice Address - Street 1:532 E. WOODIN AVE
Practice Address - Street 2:
Practice Address - City:CHELAN
Practice Address - State:WA
Practice Address - Zip Code:98816-1852
Practice Address - Country:US
Practice Address - Phone:509-679-1415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty