Provider Demographics
NPI:1497075378
Name:CASORT, BARBARA SUE (RDH,BS)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:SUE
Last Name:CASORT
Suffix:
Gender:F
Credentials:RDH,BS
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:SUE
Other - Last Name:KNUTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH, BS
Mailing Address - Street 1:5660 NORTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-9644
Mailing Address - Country:US
Mailing Address - Phone:360-312-1900
Mailing Address - Fax:
Practice Address - Street 1:5660 NORTHWEST DR
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-9644
Practice Address - Country:US
Practice Address - Phone:360-312-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00005524124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist