| Cascade Family Practice Llc | |
|
6542 Se Lake Rd Ste 202 Milwaukie OR 97222-2245 | |
| (503) 233-5273 | |
| (855) 492-8902 |
| Full Name | Cascade Family Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 6542 Se Lake Rd Ste 202, Milwaukie, Oregon |
| Authorized Official Name and Position | Carl Michael Erickson (OWNER) |
| Authorized Official Contact | 5032335273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cascade Family Practice Llc 6542 Se Lake Rd Ste 202 Milwaukie OR 97222-2245 Ph: (503) 233-5273 | Cascade Family Practice Llc 6542 Se Lake Rd Ste 202 Milwaukie OR 97222-2245 Ph: (503) 233-5273 |
| NPI Number | 1518609973 |
|---|---|
| Provider Enumeration Date | 04/07/2022 |
| Last Update Date | 05/11/2022 |
| Medicare PECOS PAC ID | 0244619351 |
|---|---|
| Medicare Enrollment ID | O20220621001550 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518609973 | NPI | - | NPPES |
| 22663-9 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Carl Michael Erickson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1710970876 PECOS PAC ID: 1850435348 Enrollment ID: I20100222000658 |
| Provider Name | Julie Catherine Leffler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750855425 PECOS PAC ID: 8022423318 Enrollment ID: I20210726000873 |
| Provider Name | Patrick Ivar Erickson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588105415 PECOS PAC ID: 4082944079 Enrollment ID: I20220902002234 |
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