Organization
CASCADE THERAPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE ELIZABETH GOMEZ LCSW (OWNER)
(503) 726-9630
Entity
Organization
Contact information
Practice address
4531 SE BELMONT ST STE 106, PORTLAND, OR 97215-1675
(503) 726-9630
Mailing address
1918 NE 143RD AVE, PORTLAND, OR 97230-4101
(503) 726-9630
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669812210
—
OR
Enumeration date
01/28/2020
Last updated
02/12/2020
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