Provider Demographics
NPI:1265032742
Name:DUSSCHEE, COURTNEY (LAC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:DUSSCHEE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12-7236 MAUKA NUI ST
Mailing Address - Street 2:
Mailing Address - City:PAHOA
Mailing Address - State:HI
Mailing Address - Zip Code:96778-8008
Mailing Address - Country:US
Mailing Address - Phone:503-989-8829
Mailing Address - Fax:
Practice Address - Street 1:12-7236 MAUKA NUI ST
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-8008
Practice Address - Country:US
Practice Address - Phone:503-989-8829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1224171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist