Provider Demographics
NPI:1740530948
Name:THOMPSON, DASIA MARIE
Entity type:Individual
Prefix:MRS
First Name:DASIA
Middle Name:MARIE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 NE 102ND AVE
Mailing Address - Street 2:APT. 41
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-4551
Mailing Address - Country:US
Mailing Address - Phone:360-521-9085
Mailing Address - Fax:
Practice Address - Street 1:213 NE 102ND AVE
Practice Address - Street 2:APT. 41
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-4551
Practice Address - Country:US
Practice Address - Phone:360-521-9085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASP602159292355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant