Provider Demographics
NPI:1578998308
Name:GERLICH, CASONDRA MYREE (CD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:CASONDRA
Middle Name:MYREE
Last Name:GERLICH
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2643 WOOD CT SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98512-9048
Mailing Address - Country:US
Mailing Address - Phone:360-402-5955
Mailing Address - Fax:
Practice Address - Street 1:2643 WOOD CT SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98512-9048
Practice Address - Country:US
Practice Address - Phone:360-402-5955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No372500000XNursing Service Related ProvidersChore Provider
No374U00000XNursing Service Related ProvidersHome Health Aide