Healthcare Provider Details

I. General information

NPI: 1023980067
Provider Name (Legal Business Name): CASSANDRA LEE ANDERSON LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2721 E SPRAGUE AVE
SPOKANE WA
99202-3940
US

IV. Provider business mailing address

2721 E SPRAGUE AVE
SPOKANE WA
99202-3940
US

V. Phone/Fax

Practice location:
  • Phone: 509-535-3038
  • Fax: 509-535-9749
Mailing address:
  • Phone: 509-535-3038
  • Fax: 509-535-9749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number114483
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: