Provider Demographics
NPI:1033683735
Name:POWER, DAVID ALAN (LMT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ALAN
Last Name:POWER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20833 67TH AVE W STE 301
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-7365
Mailing Address - Country:US
Mailing Address - Phone:425-697-0823
Mailing Address - Fax:425-673-9410
Practice Address - Street 1:20833 67TH AVE W STE 301
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-7365
Practice Address - Country:US
Practice Address - Phone:425-697-0823
Practice Address - Fax:425-673-9410
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60566449225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist