| Doctor Name: | CASEY S WYATT |
| NPI Number: | 1134403678 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | PA60245242 |
| Business Practice Address: | 900 Eastmont Ave East Wenatchee, WA - 988026602 |
| Business Phone Number: | 5098849000 |
| Business Fax Number: | 5098849001 |
| Mailing Address: | 600 Orondo Ave, Ste 1 WENATCHEE |
| State: | WA |
| Postal Code: | 988012800 |
| Phone Number: | 5096626000 |
| Fax Number: | 5096644590 |
| NPI Enumeration Date: | 10/03/2011 |
| NPI Last Update Date: | 09/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA60245242 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |