Provider Demographics
NPI:1669244497
Name:CASCADE MEDICAL IMAGING LLC
Entity type:Organization
Organization Name:CASCADE MEDICAL IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHYSICIAN ADMIN SVCS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-598-3218
Mailing Address - Street 1:1460 NE MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6061
Mailing Address - Country:US
Mailing Address - Phone:541-382-6633
Mailing Address - Fax:541-383-1615
Practice Address - Street 1:1693 SW CHANDLER AVE STE 120
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3230
Practice Address - Country:US
Practice Address - Phone:541-382-6633
Practice Address - Fax:541-383-1615
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CASCADE MEDICAL IMAGING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty