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Individual

DR. CASEY RAY MEDINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
125 N 18TH ST STE C, MOUNT VERNON, WA 98273-3902
(360) 424-6161
Mailing address
8100 CAMBRIDGE ST APT 131, HOUSTON, TX 77054-3164
(253) 230-2066

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10060352
TX
2085R0202X
Diagnostic Radiology Physician
Primary
MD61282818
WA

Other

Enumeration date
05/31/2017
Last updated
04/24/2023
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