# CASCADE WEST MEDICAL PRACTICE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cascade West Primary Care Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639468432
- **Authorized official:** MR. MICHAEL L JOHNSON (OFFICE MANAGER)
- **Authorized official phone:** (541) 450-8345

## Contact information

- **Practice address:** 201 NE SAVAGE ST, GRANTS PASS, OR 97526-1309
- **Practice address phone:** (541) 787-4360
- **Practice address fax:** (360) 216-7677
- **Mailing address:** PO BOX 738, MERLIN, OR 97532-0738
- **Mailing address phone:** (541) 787-4360
- **Mailing address fax:** (360) 216-7677

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 200850056NP | OR | Yes |

## Other

- **Enumeration date:** 04/01/2011
- **Last updated:** 04/01/2011