Organization
CASCADE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARRIE J PETERSEN CCC SLP (OWNER/PROVIDER)
(360) 230-8557
Entity
Organization
Contact information
Practice address
1220 MAIN ST STE 400, VANCOUVER, WA 98660-2963
(360) 230-8557
(888) 915-0898
Mailing address
1220 MAIN ST STE 400, VANCOUVER, WA 98660-2963
(360) 230-8557
(888) 915-0898
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
—
—
261QA3000X
Augmentative Communication Clinic/Center
—
—
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063175644
REGENCE BCBS
OR
01
—
1063175644
PREMERA
WA
01
—
1063175644
MODA
—
05
—
1063175644
—
WA
01
—
1346591153
REGENCE BCBS
OR
01
—
1346591153
TRICARE WEST
WA
05
—
1346591153
—
WA
Enumeration date
10/20/2021
Last updated
12/20/2023
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