CASCADE WEST MEDICAL PRACTICE LLC (NPI# 1639468432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639468432 |
| Entity Type | Organization |
| Organization Name | CASCADE WEST MEDICAL PRACTICE LLC |
| Other Organization Name | CASCADE WEST PRIMARY CARE CLINIC |
| Practice Address |
201 Ne Savage St Grants Pass OR 97526-1309 |
| Mailing Address |
Po Box 738 Merlin OR 97532-0738 |
| Practice Telephone | 5417874360 |
| Practice Fax Number | 3602167677 |
| Mailing Telephone | 5417874360 |
| Mailing Fax Number | 3602167677 |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2011-04-01 |
| Authorized Official Name | MR. MICHAEL L JOHNSON (OFFICE MANAGER) |
| Authorized Official Telephone | 5414508345 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
200850056NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Cascade West Primary Care Clinic | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | CASCADE WEST MEDICAL PRACTICE LLC | 210 Ne Savage St, Grants Pass, OR 97526 |
| Street Address |
201 NE SAVAGE ST |
| City | GRANTS PASS |
| State | OR |
| Zip Code | 97526-1309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134124050 | Heather Alaine Kahn | Family Medicine | 201 Ne Savage St, Grants Pass, OR 97526-1309 | 2005-06-16 |
| 1821373994 | Rosemary Monette | Dental Hygienist | 201 Ne Savage St, Grants Pass, OR 97526-1309 | 2011-10-19 |
| 1720038904 | David D. Candelaria, Md | Family Medicine | 201 Ne Savage St, Grants Pass, OR 97526-1309 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205476777 | Kyla M Mccormick | Peer Specialist | 109 Nw Manzanita Avenue, Grants Pass, OR 97526 | 2020-01-13 |
| 1164076469 | Alicia Yvonne Hansen | Counselor | 1055 Clarey St., Grants Pass, OR 97526 | 2019-07-25 |
| 1841842598 | Michael Liam Reynolds, Dds, LLC | Dentist | 984 Ne 8th Street, Grants Pass Oregon, Grants Pass, OR 97526 | 2019-07-12 |
| 1881254746 | Brandi Mccrorey | Counselor | 418 Ne 6th Street, Suite 102, Grants Pass, OR 97526 | 2019-06-13 |
| 1700364502 | Premier Community Supports, LLC. | Day Training, Developmentally Disabled Services | 1439 Ne 6th St Ste C, Grants Pass, OR 97526 | 2018-08-02 |
| 1821584509 | Stefani Mcintyre | Massage Therapist | 1590 Se N Street, Warehouse #1574, Grants Pass, OR 97526 | 2018-07-06 |
| 1114467438 | Sandra P Martin | Chiropractor | 333 Sw 5th St. Suite B, Grants Pass, OR 97526 | 2017-03-06 |
| 1801347612 | Maci Wageman | Counselor | 1215 Sw G St Grants Pass Oregon 97526, Grants Pass, OR 97526 | 2016-10-17 |
| 1902353907 | Optimal Health of Southern Oregon, LLC | Family Medicine | 1600 Nw 6th St South Suite, Grants Pass, OR 97526 | 2016-09-07 |
| 1982150793 | Tanya White | Counselor | 402 Nw Fstreet, Grants Pass, OR 97526 | 2016-08-31 |
| Find all providers in zip 97526 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003275843 | Catherine Chiaradonna | Nurse Practitioner | 1867 Williams Hwy Ste 226, Grants Pass, OR 97527-5856 | 2016-02-22 |
| 1245579408 | Derek Brent Kordenbrock | Nurse Practitioner | 625 Sw Ramsey Ave Ste A, Grants Pass, OR 97527-5808 | 2013-02-07 |
| 1003986696 | Cathryn Diann Draper | Nurse Practitioner | 520 Sw Ramsey Ave Ste 204, Grants Pass, OR 97527-5535 | 2006-11-09 |
| 1578180857 | Daniela Falcone | Nurse Practitioner | 2075 Nw Highland Ave, Grants Pass, OR 97526-3310 | 2020-07-02 |
| 1194357764 | Robert Scott Anthony | Nurse Practitioner | 2201 Nw Highland Ave, Grants Pass, OR 97526-3365 | 2020-02-11 |
| 1992951107 | Lwafp PC Inc | Nurse Practitioner | 181 Nw Bunnell Ave, Grants Pass, OR 97526-6012 | 2008-08-07 |
| 1427149392 | Victoria Lynn Vandyke | Nurse Practitioner | 1075 Sw Grandview Avenue, Suite 200, Grants Pass, OR 97527 | 2006-09-27 |
| 1174571186 | Cynthia Marie Mahoney | Nurse Practitioner | 181 Nw Bunnell Ave, Grants Pass, OR 97526-6012 | 2006-05-04 |
| 1427028224 | Linda M Picker-johnson | Nurse Practitioner | 181 Nw Bunnell Ave, Grants Pass, OR 97526-6012 | 2006-01-24 |
| 1093715922 | Heather Voss | Nurse Practitioner | 1619 Nw Hawthorne Ave, Grants Pass, OR 97526-6008 | 2005-07-21 |
| Find all providers in GRANTS PASS | ||||
| City | GRANTS PASS |
| Zip Code | 97526 |
Please comment or provide details below to improve the information on CASCADE WEST MEDICAL PRACTICE LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.