Provider Demographics
NPI:1144589300
Name:FELDMAN, NOVELITA DUYAN (LMP)
Entity Type:Individual
Prefix:MRS
First Name:NOVELITA
Middle Name:DUYAN
Last Name:FELDMAN
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 1:7448 NW IOKA DR
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9332
Mailing Address - Country:US
Mailing Address - Phone:360-471-1726
Mailing Address - Fax:
Practice Address - Street 1:24160 NORTHEAST SR-3
Practice Address - Street 2:
Practice Address - City:BELFAIR
Practice Address - State:WA
Practice Address - Zip Code:98528
Practice Address - Country:US
Practice Address - Phone:360-471-1726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60282014225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist