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General NPI Number Information
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NPI Number | 1164791653
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Entity Type | Individual
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Provider Name | JUDY LYNN KASKI LMP
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Gender | Female
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Dates
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Enumeration Date | 12/29/2011
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 4916 NE ST JOHNS RD
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City | VANCOUVER
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State | WA
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Zip | 98661-2547
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Country | US
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Telephone | 360-798-5949
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Fax | 360-993-0428
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Provider Business Mailing Address
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Address Line | 601 W JONES ST
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City | YACOLT
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State | WA
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Zip | 98675-5625
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Country | US
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Telephone | 360-798-5949
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173C00000X
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Taxonomy Name | Reflexologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA60259902
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License Number State | WA
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