Provider Demographics
NPI:1245587815
Name:IWAMASA, DAWN AYUME (MA, CCLS, MT-BC)
Entity Type:Individual
Prefix:MISS
First Name:DAWN
Middle Name:AYUME
Last Name:IWAMASA
Suffix:
Gender:F
Credentials:MA, CCLS, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 SW BARNES RD
Mailing Address - Street 2:#S104
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6372
Mailing Address - Country:US
Mailing Address - Phone:503-707-6388
Mailing Address - Fax:
Practice Address - Street 1:8150 SW BARNES RD
Practice Address - Street 2:#S104
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6372
Practice Address - Country:US
Practice Address - Phone:503-707-6388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist