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NPI Code Detail

MEDICARE: DANIEL LEE CASTENSON PA

MEDICARE: DANIEL LEE CASTENSON PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA10002004WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00350851OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10212901OTHERWALABOR & IND. WA STATE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
48942418OTHERWACRIME VICTIMS WA STATE

General Provider Information

NPI Number : 1760597496
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL LEE CASTENSON PA
Provider Business Mailing Address
First Line : PO BOX 3002
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-0302
Country : US
Telephone Number : 360-747-5800
Fax Number :
Provider Business Practice Location Address
First Line : 1718 E KESSLER BLVD
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-1842
Country : US
Telephone Number : 360-747-5800
Fax Number : 360-575-3846
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2006
Last Update Date : 07/30/2012

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Directions to “ DANIEL LEE CASTENSON PA” Practice Location

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