Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NS0005X | Chiropractic Sports Physician | 3299 OR | OR |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 201600042NP | OR |
NPI | 1124078175 |
---|---|
Provider Name | Dr. Billie J Kaskasuto |
First Address | Enterprise, OR 97828-1427 |
Second Address | Enterprise, OR 97828-1427 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 11/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U61156 | (02) | OR |