Provider Demographics
NPI:1457496184
Name:CASEBEER, RONALD L (MED)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:L
Last Name:CASEBEER
Suffix:
Gender:M
Credentials:MED
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 1120
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:WA
Mailing Address - Zip Code:99166-1120
Mailing Address - Country:US
Mailing Address - Phone:509-775-3341
Mailing Address - Fax:509-775-8906
Practice Address - Street 1:65 NORTH KELLER STREET
Practice Address - Street 2:
Practice Address - City:REPUBLIC
Practice Address - State:WA
Practice Address - Zip Code:99166
Practice Address - Country:US
Practice Address - Phone:509-775-3341
Practice Address - Fax:509-775-8906
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60158922.101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health