Provider Demographics
NPI:1215307251
Name:CASELDINE, ROBERTA H (OT)
Entity type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:H
Last Name:CASELDINE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2222
Mailing Address - Fax:
Practice Address - Street 1:100 DENNIS ST SW
Practice Address - Street 2:STE A
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-6523
Practice Address - Country:US
Practice Address - Phone:360-704-3300
Practice Address - Fax:360-704-7676
Is Sole Proprietor?:No
Enumeration Date:2015-10-02
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 00003983225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation