Healthcare Provider Details

I. General information

NPI: 1124368543
Provider Name (Legal Business Name): CASSI FLINT LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2013
Last Update Date: 02/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9776 HOLMAN RD NW
SEATTLE WA
98117-2000
US

IV. Provider business mailing address

10716 LINDEN AVE N
SEATTLE WA
98133-8820
US

V. Phone/Fax

Practice location:
  • Phone: 206-782-8800
  • Fax:
Mailing address:
  • Phone: 360-510-2446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberMA60335550
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: