Provider Demographics
NPI:1174924898
Name:DESCH, CAITLIN MARIE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:MARIE
Last Name:DESCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:CAITLIN
Other - Middle Name:MARIE
Other - Last Name:KEILTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:360-293-4343
Mailing Address - Fax:360-588-1587
Practice Address - Street 1:912 32ND ST
Practice Address - Street 2:SUITE A
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-3473
Practice Address - Country:US
Practice Address - Phone:360-293-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-12
Last Update Date:2023-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60602093363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant