Provider Demographics
NPI:1447561840
Name:DALTON, NEWMAN LEE IV (MA)
Entity Type:Individual
Prefix:MR
First Name:NEWMAN
Middle Name:LEE
Last Name:DALTON
Suffix:IV
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:323 QUEEN ANNE AVE N STE 1
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4553
Mailing Address - Country:US
Mailing Address - Phone:206-352-8191
Mailing Address - Fax:206-352-8191
Practice Address - Street 1:323 QUEEN ANNE AVE N STE 1
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4553
Practice Address - Country:US
Practice Address - Phone:206-352-8191
Practice Address - Fax:206-352-8191
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMA60159297225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist