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NPI Code Detail

MEDICARE: KEVIN CASSIDY

MEDICARE: KEVIN CASSIDY
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1730500224
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN CASSIDY
Provider Business Mailing Address
First Line : 2212 S JACKSON ST
Second Line :
City : SEATTLE
State : WA
Zip : 98144-2591
Country : US
Telephone Number : 206-329-6485
Fax Number :
Provider Business Practice Location Address
First Line : 2212 S JACKSON ST
Second Line :
City : SEATTLE
State : WA
Zip : 98144-2591
Country : US
Telephone Number : 206-329-6485
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2013
Last Update Date : 07/26/2024

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Directions to “ KEVIN CASSIDY ” Practice Location

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