Provider Demographics
NPI:1225333107
Name:DUMYAHN, TERRYANN
Entity Type:Individual
Prefix:
First Name:TERRYANN
Middle Name:
Last Name:DUMYAHN
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 1:11324 SCHOOL LAND RD SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:WA
Mailing Address - Zip Code:98579-9677
Mailing Address - Country:US
Mailing Address - Phone:815-878-1327
Mailing Address - Fax:
Practice Address - Street 1:11324 SCHOOL LAND RD SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:WA
Practice Address - Zip Code:98579-9677
Practice Address - Country:US
Practice Address - Phone:815-878-1327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-24
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
WALW608032561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical