Provider Demographics
NPI:1578821435
Name:TOOMIM, DONALD EMANUEL (LMT)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:EMANUEL
Last Name:TOOMIM
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:12945 SW GLENN DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-5141
Mailing Address - Country:US
Mailing Address - Phone:707-206-2850
Mailing Address - Fax:503-530-8972
Practice Address - Street 1:12555 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-0546
Practice Address - Country:US
Practice Address - Phone:707-206-2850
Practice Address - Fax:503-530-8972
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA173C00000X
OR17500225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist