Provider Demographics
NPI:1497158414
Name:KINTNER, CASSADY
Entity Type:Individual
Prefix:
First Name:CASSADY
Middle Name:
Last Name:KINTNER
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 1:2606 1/2 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-1214
Mailing Address - Country:US
Mailing Address - Phone:425-224-6565
Mailing Address - Fax:
Practice Address - Street 1:2606 1/2 3RD AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1214
Practice Address - Country:US
Practice Address - Phone:425-224-6565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-04
Last Update Date:2014-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program