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FQHCLA433E Cascadia Health (Active)
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Main Details
Name
Cascadia Health
Subdivision Name
Cascadia Plaza Health Center 200
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-035651
340B ID
FQHCLA433E
Grant Number
LALCS40208
Additional Details
Current Program Status
Active
Registration Date
10/12/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/3/2022
Last Recertification Date
2/14/2025
Contacts
Authorizing Official
Cascadia Health
Robert Trachtenberg, Senior Director Health Center Operations
(503) 963-7661
Primary Contact
Cascadia Health
Deryk Coker, 340B Compliance Specialist
(503) 238-0769
Addresses
Street Address
4212 SE Division Street STE 200
Portland, OR 97206-1600
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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