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NPI Code Detail

MEDICARE: DEREK R CASTONGUAY PT

MEDICARE: DEREK R CASTONGUAY PT
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
1225100000XPhysical TherapistPT00009677WA

General Provider Information

NPI Number : 1992753313
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEREK R CASTONGUAY PT
Provider Business Mailing Address
First Line : 1100 OLIVE WAY
Second Line : MS:M4-PA
City : SEATTLE
State : WA
Zip : 98101-1873
Country : US
Telephone Number : 206-515-5811
Fax Number :
Provider Business Practice Location Address
First Line : 33501 FRIST WAY SOUTH
Second Line :
City : FEDERAL WAY
State : WA
Zip : 98003-6208
Country : US
Telephone Number : 253-838-2400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2006
Last Update Date : 04/10/2008

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Directions to “ DEREK R CASTONGUAY PT” Practice Location

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