Provider Demographics
NPI:1659001873
Name:NOWINSKI, DEVYN ALYSE (LMP)
Entity Type:Individual
Prefix:
First Name:DEVYN
Middle Name:ALYSE
Last Name:NOWINSKI
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 1:15615 BEL RED RD STE A
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-2300
Mailing Address - Country:US
Mailing Address - Phone:425-883-0133
Mailing Address - Fax:
Practice Address - Street 1:15615 BEL RED RD STE A
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-2300
Practice Address - Country:US
Practice Address - Phone:425-883-0133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-11
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60989668225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA60989668OtherMASSAGE