Provider Demographics
NPI:1174944169
Name:HODGIN, CASSIE MARIE (ATC)
Entity type:Individual
Prefix:MS
First Name:CASSIE
Middle Name:MARIE
Last Name:HODGIN
Suffix:
Gender:F
Credentials:ATC
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Mailing Address - Street 1:BOHLER ATHLETIC COMPLEX M4
Mailing Address - Street 2:P.O. BOX 641602
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99164-1602
Mailing Address - Country:US
Mailing Address - Phone:509-335-0912
Mailing Address - Fax:509-335-4729
Practice Address - Street 1:1455 COLORADO ST
Practice Address - Street 2:BOHLER ATHLETIC COMPLEX M4
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99164
Practice Address - Country:US
Practice Address - Phone:509-335-0912
Practice Address - Fax:509-335-4729
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAA1 604078112255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer