Provider Demographics
NPI:1114591823
Name:FALZONE, DEANNE
Entity Type:Individual
Prefix:
First Name:DEANNE
Middle Name:
Last Name:FALZONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3952 S EDMUNDS ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-1716
Mailing Address - Country:US
Mailing Address - Phone:312-618-3614
Mailing Address - Fax:
Practice Address - Street 1:3952 S EDMUNDS ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-1716
Practice Address - Country:US
Practice Address - Phone:312-618-3614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61141413225700000X
WA61141413225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty