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General NPI Number Information
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NPI Number | 1376608281
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Entity Type | Individual
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Provider Name | RANDY D CASTLEMAN PT
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Gender | Male
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 04/03/2024
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Provider Practice Location Address
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Address Line | 56 N COLLEGE AVE UNIT 1
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City | COLLEGE PLACE
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State | WA
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Zip | 99324-1048
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Country | US
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Telephone | 509-540-9318
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Fax |
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Provider Business Mailing Address
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Address Line | 85081 TUM A LUM RD
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City | MILTON FREEWATER
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State | OR
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Zip | 97862-7411
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Country | US
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Telephone | 509-540-9318
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4284
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT00007989
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License Number State | WA
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