Organization
CASCADE SPINE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC BOON (OFFIICER/AUTHORIZED OFFICIAL)
(480) 567-0269
Entity
Organization
Contact information
Practice address
6464 SW BORLAND RD, BLDG A STE A-3, TUALATIN, OR 97062-8876
(971) 404-3366
(971) 404-3377
Mailing address
6464 SW BORLAND RD, BLDG A STE A-3, TUALATIN, OR 97062-8876
(971) 404-3366
(971) 404-3377
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
071546
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299326
—
OR
01
—
P00082443
RAILROAD MEDICARE
OR
Enumeration date
06/17/2005
Last updated
09/18/2024
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