Provider Demographics
NPI:1134352750
Name:MCQUAID, KASEY LANE (LMP)
Entity type:Individual
Prefix:MISS
First Name:KASEY
Middle Name:LANE
Last Name:MCQUAID
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 1:7502 35TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-4811
Mailing Address - Country:US
Mailing Address - Phone:206-522-6339
Mailing Address - Fax:206-528-2152
Practice Address - Street 1:7502 35TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-4811
Practice Address - Country:US
Practice Address - Phone:206-522-6339
Practice Address - Fax:206-528-2152
Is Sole Proprietor?:No
Enumeration Date:2009-08-30
Last Update Date:2009-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60016427172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist