Ellen Barbara Cassill, RDH
Individual provider Active NPI Dental Hygienist · Lake Tapps, WA
NPI 1457543423 · NPPES record last updated Aug 14, 2007
Key facts
- NPI
- 1457543423
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- DH00002017 (WA)
- Practice address
- 18526 Driftwood Dr E
Lake Tapps, WA 98391-9466 - Phone
- (253) 862-7819
- NPI assigned
- Aug 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DH00002017 | WA | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH00002017 | WA | Yes |
Addresses
Primary practice location
18526 Driftwood Dr E
Lake Tapps, WA 98391-9466
Mailing address
18526 Driftwood Dr E
Lake Tapps, WA 98391
Phone (253) 862-7819
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5902058 | Medicaid | WA |
Other providers in Lake Tapps, WA
- Rebekah Betts
- Rupinder Bhuller
- Linda M Bowman
- Beth Burris
- Julie Cardenas
- Alex Mauricio Castro
- Rachelle Caviness
- Lila M Day
- Dieringer School District
- Dljohnson, Inc PS
All providers in Lake Tapps, WA · Dental Hygienist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.