Provider Demographics
NPI:1952502981
Name:CASADY, CHRISTINA (OTRL)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:CASADY
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 N MILDRED ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-1725
Mailing Address - Country:US
Mailing Address - Phone:253-565-0438
Mailing Address - Fax:253-564-6012
Practice Address - Street 1:633 N MILDRED ST
Practice Address - Street 2:SUITE A
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-1725
Practice Address - Country:US
Practice Address - Phone:253-565-0438
Practice Address - Fax:253-564-6012
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00000639174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA120614OtherDEPT. LABOR & INDUSTRIES