Provider Demographics
NPI:1083885065
Name:HILL, DANA CORINNE (LMP)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:CORINNE
Last Name:HILL
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:CORINNE
Other - Last Name:DIEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3045
Mailing Address - Street 2:SUITE F
Mailing Address - City:YELM
Mailing Address - State:WA
Mailing Address - Zip Code:98597
Mailing Address - Country:US
Mailing Address - Phone:360-458-2225
Mailing Address - Fax:360-458-3663
Practice Address - Street 1:715 EAST YELM AVE #5
Practice Address - Street 2:SUITE F
Practice Address - City:ROY
Practice Address - State:WA
Practice Address - Zip Code:98597
Practice Address - Country:US
Practice Address - Phone:360-458-2225
Practice Address - Fax:360-458-3663
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021061225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist