Provider Demographics
NPI:1164852034
Name:CHAPMAN, DANA LEE (LMP)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:LEE
Last Name:CHAPMAN
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 1:2115 SE 192ND AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-7479
Mailing Address - Country:US
Mailing Address - Phone:360-833-2868
Mailing Address - Fax:360-833-2866
Practice Address - Street 1:2115 SE 192ND AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-7479
Practice Address - Country:US
Practice Address - Phone:360-833-2868
Practice Address - Fax:360-833-2866
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60408020225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist