Provider Demographics
NPI:1437322138
Name:DENNING, MANDI LYNN (LMP)
Entity Type:Individual
Prefix:
First Name:MANDI
Middle Name:LYNN
Last Name:DENNING
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 1:1256 SE BISHOP BLVD STE J
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-5414
Mailing Address - Country:US
Mailing Address - Phone:509-432-6506
Mailing Address - Fax:509-334-6768
Practice Address - Street 1:1256 SE BISHOP BLVD STE J
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5414
Practice Address - Country:US
Practice Address - Phone:509-432-6506
Practice Address - Fax:509-334-6768
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00019018225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0197378OtherWASHINGTON STATE L & I
WA2929 DEOtherREGENCE