Provider Demographics
NPI:1538496633
Name:REDMAN, CASEY MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:MARIE
Last Name:REDMAN
Suffix:
Gender:F
Credentials:DPT
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 67
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98930-0067
Mailing Address - Country:US
Mailing Address - Phone:360-631-0627
Mailing Address - Fax:
Practice Address - Street 1:1300 APRICOT RD
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:WA
Practice Address - Zip Code:98930-8900
Practice Address - Country:US
Practice Address - Phone:360-631-0627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPU60106533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist