Healthcare Provider Details

I. General information

NPI: 1326191305
Provider Name (Legal Business Name): CASSIE T SIPE RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CASSIE T SIPE DIETICIAN

II. Dates (important events)

Enumeration Date: 01/21/2007
Last Update Date: 02/21/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

U.S. NAVAL HOSPITAL GUAM BLDG 50, FARENHOLT AVENUE
AGANA HEIGHTS GU
96910
US

IV. Provider business mailing address

U.S. NAVAL HOSPITAL GUAM PSC 455 BOX 208
FPO AP
96540
US

V. Phone/Fax

Practice location:
  • Phone: 671-344-9340
  • Fax:
Mailing address:
  • Phone: 671-344-9340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: