Provider Demographics
NPI:1568777134
Name:HUNTER, DEANNA MARIE (LMP)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:MARIE
Last Name:HUNTER
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 1:7125 SW ALTA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-7312
Mailing Address - Country:US
Mailing Address - Phone:360-895-5466
Mailing Address - Fax:
Practice Address - Street 1:24160 NE STATE ROUTE 3
Practice Address - Street 2:
Practice Address - City:BELFAIR
Practice Address - State:WA
Practice Address - Zip Code:98528-9626
Practice Address - Country:US
Practice Address - Phone:360-205-3085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-08
Last Update Date:2010-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60106143225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist