# CASCADE EYE & SKIN CENTERS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cascade Laser & Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699817346
- **Authorized official:** NICOLE JELMBERG-BRAYTON (BUSINESS OPERATIONS MANAGER)
- **Authorized official phone:** (253) 446-3904

## Contact information

- **Practice address:** 1703 S MERIDIAN STE 201, PUYALLUP, WA 98371-7590
- **Practice address phone:** (253) 848-3000
- **Mailing address:** 1703 S MERIDIAN, SUITE 101, PUYALLUP, WA 98371-7590
- **Mailing address phone:** (253) 770-7708
- **Mailing address fax:** (253) 770-7630

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 601325507 | WA | Yes |

## Other

- **Enumeration date:** 02/12/2007
- **Last updated:** 03/11/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 111019 | WA. STATE LABOR & INDUSTR | WA |
| 05 | — | 7079189 | — | WA |