Provider Demographics
NPI:1851043640
Name:TRAN, CASANDRA FAITH CAPON (ARNP)
Entity type:Individual
Prefix:
First Name:CASANDRA FAITH
Middle Name:CAPON
Last Name:TRAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:11122 125TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-7602
Mailing Address - Country:US
Mailing Address - Phone:253-232-0835
Mailing Address - Fax:
Practice Address - Street 1:2120 RYAN RD
Practice Address - Street 2:
Practice Address - City:BUCKLEY
Practice Address - State:WA
Practice Address - Zip Code:98321-9115
Practice Address - Country:US
Practice Address - Phone:360-829-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-22
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60137081163W00000X
WAAP61218545363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse