Provider Demographics
NPI:1306862453
Name:DEMMON, ALLISON MARIE (LMP)
Entity Type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:MARIE
Last Name:DEMMON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1113
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98291-1113
Mailing Address - Country:US
Mailing Address - Phone:253-820-4606
Mailing Address - Fax:
Practice Address - Street 1:127 AVENUE C
Practice Address - Street 2:SUITE A
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2768
Practice Address - Country:US
Practice Address - Phone:360-568-4185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013728225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2002090649932OtherCIGNA
WA8905DEOtherREGENCE
WA0159641OtherLABOR AND INDUSTRIES
WA219566OtherL&I
WA5382DEOtherPERSONAL REGENCE NUMBER