Individual
DR. CASEY D SUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
160 WAPATO WAY, MANSON, WA 98831
(509) 687-9221
(509) 687-9201
Mailing address
PO BOX 405, MANSON, WA 98831-0405
(509) 687-9221
(509) 687-9201
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60565498
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841746427
INSURANCE
WA
Enumeration date
08/09/2012
Last updated
07/03/2018
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