MEDICARE: MRS. CASIMIRA DOMINGA VALDEZ L.M.P.

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
1	225700000X	Massage Therapist	WA00020974	WA

General Provider Information

NPI Number	:	1780724492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CASIMIRA DOMINGA VALDEZ L.M.P.

Provider Business Mailing Address
First Line	:	2716 E 13TH ST
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98661-4799
Country	:	US
Telephone Number	:	360-826-7266
Fax Number	:	360-826-7266

Provider Business Practice Location Address
First Line	:	2402 BROADWAY ST
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98663-3229
Country	:	US
Telephone Number	:	360-241-6630
Fax Number	:	360-567-0620

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	12/02/2025

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