MEDICARE: MR. ALBERT COSMAS CASALE MSW

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	1041C0700X	Clinical Social Worker	LW00004503	WA

General Provider Information

NPI Number	:	1922261924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALBERT COSMAS CASALE MSW

Provider Business Mailing Address
First Line	:	6107 CHENNAULT BEACH DR
Second Line	:
City	:	MUKILTEO
State	:	WA
Zip	:	98275-4663
Country	:	US
Telephone Number	:	425-374-3824
Fax Number	:	425-374-3825

Provider Business Practice Location Address
First Line	:	6107 CHENNAULT BEACH DR
Second Line	:
City	:	MUKILTEO
State	:	WA
Zip	:	98275-4663
Country	:	US
Telephone Number	:	425-374-3824
Fax Number	:	425-374-3825

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

Provider Enumeration Date	:	07/09/2008
Last Update Date	:	07/09/2008

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