Provider Demographics
NPI:1316427834
Name:REPASKY, CASSANDRA MAE
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:MAE
Last Name:REPASKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 N 11TH ST APT 6
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-1223
Mailing Address - Country:US
Mailing Address - Phone:719-433-3263
Mailing Address - Fax:
Practice Address - Street 1:3801 5TH ST SE STE 220
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-2106
Practice Address - Country:US
Practice Address - Phone:253-445-4258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist