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Individual

JENNIFER CASERTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1911 COOKS HILL RD, CENTRALIA, WA 98531-9073
(360) 736-6778
(360) 736-6552
Mailing address
1911 COOKS HILL RD, CENTRALIA, WA 98531-9073
(360) 736-6778
(360) 736-6552

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00043677
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
230532008
GROUP HEALTH
WA
01
2914CA
REGENCE
WA
05
7057375
WA
05
7122617
WA
05
7131709
WA
05
7131717
WA
05
8398356
WA
01
9116CA
REGENCE
WA
Enumeration date
03/28/2007
Last updated
07/09/2007
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