Provider Demographics
NPI:1275962318
Name:DUNAGAN, DAWN (MASSAGE THERAPY)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:DUNAGAN
Suffix:
Gender:F
Credentials:MASSAGE THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17922 E 11TH CT
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:WA
Mailing Address - Zip Code:99016-8658
Mailing Address - Country:US
Mailing Address - Phone:509-939-9103
Mailing Address - Fax:
Practice Address - Street 1:22910 E APPLEWAY AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-8605
Practice Address - Country:US
Practice Address - Phone:509-242-0911
Practice Address - Fax:509-242-0913
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60306578174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist