Provider Demographics
NPI:1508988965
Name:GOSSE, DINA K (LAC, LMP)
Entity Type:Individual
Prefix:MS
First Name:DINA
Middle Name:K
Last Name:GOSSE
Suffix:
Gender:F
Credentials:LAC, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12324 415TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-9414
Mailing Address - Country:US
Mailing Address - Phone:425-831-5231
Mailing Address - Fax:425-732-4488
Practice Address - Street 1:12324 415TH AVE SE
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045-9414
Practice Address - Country:US
Practice Address - Phone:425-831-5231
Practice Address - Fax:425-732-4488
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 9696225700000X
WAAC60002803171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist