MEDICARE: KARIS CASAGRANDE PHD

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
1	103TC0700X	Clinical Psychologist	PY61358961	WA

General Provider Information

NPI Number	:	1801425475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARIS CASAGRANDE PHD

Provider Business Mailing Address
First Line	:	6901 SAND POINT WAY NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-7869
Country	:	US
Telephone Number	:	206-987-8080
Fax Number	:

Provider Business Practice Location Address
First Line	:	6901 SAND POINT WAY NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-7869
Country	:	US
Telephone Number	:	206-987-8080
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2020
Last Update Date	:	12/14/2023

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Directions to “ KARIS CASAGRANDE PHD” Practice Location

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