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Organization
CASCADE PHYSICIANS, P.C.
Active
Organization
CASCADE PHYSICIANS, P.C.
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINO (DIRECTORS OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
19250 SW 65TH AVE, 110, TUALATIN, OR 97062-7452
(503) 692-1205
Mailing address
PO BOX 86309, PORTLAND, OR 97286-0309
(503) 242-9850
(503) 226-3539
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
332900000X
Non-Pharmacy Dispensing Site
MD13393
OR
Other
Enumeration date
02/10/2007
Last updated
01/26/2023
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