Individual
GREGORY T CAUDILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
122 3RD ST NE, AUBURN, WA 98002-4098
(253) 833-7750
(253) 833-7469
Mailing address
122 3RD ST NE, AUBURN, WA 98002-4098
(253) 833-7750
(253) 887-9804
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10001883
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130067
DEPT OF L&I
WA
Enumeration date
07/21/2005
Last updated
02/14/2020
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