Organization
CASCADE PHYSICIANS, P.C.
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINO (DIRECTORS OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
19250 SW 65TH AVE, 110, TUALATIN, OR 97062-7452
(503) 692-1205
Mailing address
PO BOX 86309, PORTLAND, OR 97286-0309
(503) 242-9850
(503) 226-3539
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
332900000X
Non-Pharmacy Dispensing Site
MD13393
OR
Other
Enumeration date
02/10/2007
Last updated
01/26/2023
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