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NPI Code Detail

MEDICARE: CASSANDRA SERENE DENGLER ARNP, PMHNP

MEDICARE: CASSANDRA SERENE DENGLER ARNP, PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAP61574970WA

General Provider Information

NPI Number : 1336983105
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA SERENE DENGLER ARNP, PMHNP
Provider Business Mailing Address
First Line : 1730 LABOUNTY DR STE 9-24
Second Line :
City : FERNDALE
State : WA
Zip : 98248-8959
Country : US
Telephone Number : 360-404-7463
Fax Number : 360-282-0734
Provider Business Practice Location Address
First Line : 117 N 1ST ST STE 55
Second Line :
City : MOUNT VERNON
State : WA
Zip : 98273-2858
Country : US
Telephone Number : 360-588-4950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2024
Last Update Date : 10/23/2024

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