Organization
CASCADE MEDICAL GROUP PS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY L BROWN M.D. (MEDICAL DIRECTOR)
(360) 336-2178
Entity
Organization
Contact information
Practice address
111 S 13TH ST, MOUNT VERNON, WA 98274-4105
(360) 336-2178
Mailing address
111 S 13TH ST, MOUNT VERNON, WA 98274-4105
(360) 336-2178
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
—
207YS0123X
Facial Plastic Surgery Physician
—
—
207YX0602X
Otolaryngic Allergy Physician
—
—
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
—
208200000X
Plastic Surgery Physician
—
—
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
—
—
208600000X
Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
2086X0206X
Surgical Oncology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7044001
—
WA
Enumeration date
03/02/2006
Last updated
10/04/2007
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