Individual
MS. COURTNEY LEAH KASSOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
209 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4265
(253) 596-3300
(253) 596-3301
Mailing address
209 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4265
(253) 596-3300
(253) 596-3301
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
2053
MA
363AS0400X
Surgical Physician Assistant
PA06311
TX
363AS0400X
Surgical Physician Assistant
Primary
PA60874684
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305018906
—
TX
Enumeration date
02/15/2007
Last updated
04/22/2021
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