Provider Demographics
NPI:1053039149
Name:OMAN, CASEY (PA-C)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:OMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:
Other - Last Name:BURKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22850 NE 8TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-7275
Mailing Address - Country:US
Mailing Address - Phone:425-898-0305
Mailing Address - Fax:425-898-8825
Practice Address - Street 1:22850 NE 8TH ST STE 103
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-7275
Practice Address - Country:US
Practice Address - Phone:425-898-0305
Practice Address - Fax:425-898-8825
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA61478820363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant