NPI Code Details Logo

NPI 1629441951

NPI 1629441951 : CASEY ELIZABETH SHUTT-HOBLET PT, DPT, DSC : JOINT BASE LEWIS MCCHORD, WA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1629441951
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    CASEY ELIZABETH SHUTT-HOBLET PT, DPT, DSC
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    11/09/2015
-----------------------------------------------------
    Last Update Date     |    08/20/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    9040A JACKSON AVENUE 
-----------------------------------------------------
    City                 |    JOINT BASE LEWIS MCCHORD
-----------------------------------------------------
    State                |    WA
-----------------------------------------------------
    Zip                  |    98431-4504
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    253-968-1110
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    9040A JACKSON AVENUE 
-----------------------------------------------------
    City                 |    JOINT BASE LEWIS MCCHORD
-----------------------------------------------------
    State                |    WA
-----------------------------------------------------
    Zip                  |    98431-0001
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225100000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Therapist
-----------------------------------------------------
    License Number       |    P16005
-----------------------------------------------------
    License Number State |    NC
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.