Organization
CASCADE PARK SPORTS MEDICINE & REHAB CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCAS Q HOMER DC (OWNER)
(360) 254-4040
Entity
Organization
Contact information
Practice address
12214 SE MILL PLAIN BLVD, STE 101, VANCOUVER, WA 98684-6019
(360) 254-4040
(360) 253-7808
Mailing address
12214 SE MILL PLAIN BLVD, STE 101, VANCOUVER, WA 98684-6019
(360) 254-4040
(360) 253-7808
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00002108
WA
Other
Enumeration date
12/01/2006
Last updated
09/13/2007
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