Provider Demographics
NPI:1013156165
Name:CASALI, TONYA LEE (LMP)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:LEE
Last Name:CASALI
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 ASTOR ST STE 102
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-2915
Mailing Address - Country:US
Mailing Address - Phone:360-306-5317
Mailing Address - Fax:360-306-5742
Practice Address - Street 1:1303 ASTOR ST STE 102
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-2915
Practice Address - Country:US
Practice Address - Phone:360-306-5317
Practice Address - Fax:360-306-5742
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018109225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist