Provider Demographics
NPI:1225467228
Name:DANA BRASWELL DOSS LLC
Entity Type:Organization
Organization Name:DANA BRASWELL DOSS LLC
Other - Org Name:DUNGENESS SPEECH AND LANGUAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:BRASWELL
Authorized Official - Last Name:DOSS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:360-683-5010
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:CARLSBORG
Mailing Address - State:WA
Mailing Address - Zip Code:98324-0040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:803 CARLSBORG RD
Practice Address - Street 2:SUITE C
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-6710
Practice Address - Country:US
Practice Address - Phone:360-683-5010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-11
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 00001446235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty