Provider Demographics
NPI:1447409354
Name:DAHN, KRISTIN CABRAL (LMP)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:CABRAL
Last Name:DAHN
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 253
Mailing Address - Street 2:
Mailing Address - City:SUMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98295-0253
Mailing Address - Country:US
Mailing Address - Phone:360-988-0533
Mailing Address - Fax:
Practice Address - Street 1:617 CHERRY STREET SUMAS PROFESSIONAL BUILDING
Practice Address - Street 2:103 & 104
Practice Address - City:SUMAS
Practice Address - State:WA
Practice Address - Zip Code:98295-0253
Practice Address - Country:US
Practice Address - Phone:360-988-0533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016584172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist