Organization
CASCADE ORTHOPAEDIC GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA WOOD GIBSON (MANAGER)
(503) 692-5483
Entity
Organization
Contact information
Practice address
6485 SW BORLAND RD STE A, TUALATIN, OR 97062-9762
(503) 692-5483
(503) 691-2757
Mailing address
6485 SW BORLAND RD STE A, TUALATIN, OR 97062-9762
(503) 692-5483
(503) 691-2757
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200002070
MEDICARE RAILROAD
—
01
—
R0000BHHZN
MEDICARE PTAN
OR
Enumeration date
11/06/2009
Last updated
04/25/2017
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