Provider Demographics
NPI:1588841647
Name:DOWNS, LORRIE ELEN (LMT CCST)
Entity Type:Individual
Prefix:MS
First Name:LORRIE
Middle Name:ELEN
Last Name:DOWNS
Suffix:
Gender:F
Credentials:LMT CCST
Other - Prefix:MS
Other - First Name:LORRIE
Other - Middle Name:ELEN
Other - Last Name:DOWNS CARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:1319 N GOVERNMENT WAY
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814
Mailing Address - Country:US
Mailing Address - Phone:208-667-3813
Mailing Address - Fax:
Practice Address - Street 1:1319 N GOVERNMENT WAY
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814
Practice Address - Country:US
Practice Address - Phone:208-667-3813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00010624225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist