Provider Demographics
NPI:1275168866
Name:DROHAN, VIRGINIA (LMT)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:DROHAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 SW 332ND ST APT 308
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-6234
Mailing Address - Country:US
Mailing Address - Phone:253-306-3901
Mailing Address - Fax:
Practice Address - Street 1:2209 N 30TH ST STE 2
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-3352
Practice Address - Country:US
Practice Address - Phone:253-448-0133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61012148225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist