Provider Demographics
NPI:1043525181
Name:CASTRO, EXPEDITA L
Entity Type:Individual
Prefix:MISS
First Name:EXPEDITA
Middle Name:L
Last Name:CASTRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7201 HOLLY HEDGE LN SW
Mailing Address - Street 2:#10
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-1848
Mailing Address - Country:US
Mailing Address - Phone:253-589-6598
Mailing Address - Fax:
Practice Address - Street 1:7201 HOLLY HEDGE LN SW
Practice Address - Street 2:#10
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-1848
Practice Address - Country:US
Practice Address - Phone:253-589-6598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00010155207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine