Basic Information
| Provider Information | |||||||||
| NPI: | 1407808785 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CASE | ||||||||
| FirstName: | EDWARD | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 530 LILLY RD SE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | OLYMPIA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985012105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3609153222 | ||||||||
| FaxNumber: | 3604914947 | ||||||||
| Practice Location | |||||||||
| Address1: | 3102 EAST HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | PATTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92369 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094257000 | ||||||||
| FaxNumber: | 9094257520 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 05/11/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | MD00047111 | WA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.