Provider Demographics
NPI:1598036253
Name:STINSON, DINAH (LMP)
Entity Type:Individual
Prefix:MS
First Name:DINAH
Middle Name:
Last Name:STINSON
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 1:384 MOUNTS RD
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-9130
Mailing Address - Country:US
Mailing Address - Phone:360-977-0046
Mailing Address - Fax:
Practice Address - Street 1:2369 DISCOVERY PL
Practice Address - Street 2:
Practice Address - City:LANGLEY
Practice Address - State:WA
Practice Address - Zip Code:98260-8304
Practice Address - Country:US
Practice Address - Phone:360-977-0046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60203274225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist