Organization
CASCADE WEST MEDICAL PRACTICE LLC
Active
Other names
Cascade West Primary Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL L JOHNSON (OFFICE MANAGER)
(541) 450-8345
Entity
Organization
Contact information
Practice address
201 NE SAVAGE ST, GRANTS PASS, OR 97526-1309
(541) 787-4360
(360) 216-7677
Mailing address
PO BOX 738, MERLIN, OR 97532-0738
(541) 787-4360
(360) 216-7677
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
200850056NP
OR
Other
Enumeration date
04/01/2011
Last updated
04/01/2011
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