Provider Demographics
NPI:1073604500
Name:STRUNK, CASSANDRA KAYE (FDN-P, LMT)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:KAYE
Last Name:STRUNK
Suffix:
Gender:F
Credentials:FDN-P, LMT
Other - Prefix:MISS
Other - First Name:CASSANDRA
Other - Middle Name:KAYE
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:6093 E GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83716-9075
Mailing Address - Country:US
Mailing Address - Phone:425-308-1553
Mailing Address - Fax:
Practice Address - Street 1:6093 E GATEWAY DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83716-9075
Practice Address - Country:US
Practice Address - Phone:425-308-1553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMAS-4236225700000X
WAMA00021177225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist