Provider Demographics
NPI:1003247636
Name:FIELD, DSHAWN (LMP)
Entity Type:Individual
Prefix:
First Name:DSHAWN
Middle Name:
Last Name:FIELD
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 BELLEVUE AVE APT 303
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2065
Mailing Address - Country:US
Mailing Address - Phone:206-353-3320
Mailing Address - Fax:
Practice Address - Street 1:1641 BELLEVUE AVE APT 303
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2065
Practice Address - Country:US
Practice Address - Phone:206-353-3320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-08
Last Update Date:2013-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60363513225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist