Provider Demographics
NPI:1063651321
Name:DOLLAHITE, STEVE C (LMP)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:C
Last Name:DOLLAHITE
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2223 112TH AVE NE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-2952
Mailing Address - Country:US
Mailing Address - Phone:425-885-4325
Mailing Address - Fax:425-283-4325
Practice Address - Street 1:2223 112TH AVE NE
Practice Address - Street 2:SUITE 201
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-2952
Practice Address - Country:US
Practice Address - Phone:425-885-4325
Practice Address - Fax:425-283-4325
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016882172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist