Provider Demographics
NPI:1376506949
Name:CASWELL, DEAN K (PT)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:K
Last Name:CASWELL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13306
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98082-1306
Mailing Address - Country:US
Mailing Address - Phone:425-686-8664
Mailing Address - Fax:425-955-0425
Practice Address - Street 1:23210 9TH PL W
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-7310
Practice Address - Country:US
Practice Address - Phone:425-686-8404
Practice Address - Fax:425-955-0495
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008993225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8905395Medicare PIN