Provider Demographics
NPI:1790287910
Name:DUNBAR, KAYLA MEGHAN (LMT)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:MEGHAN
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2132 178TH ST SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6562
Mailing Address - Country:US
Mailing Address - Phone:703-638-2717
Mailing Address - Fax:
Practice Address - Street 1:2132 178TH ST SE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-6562
Practice Address - Country:US
Practice Address - Phone:703-638-2717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-03
Last Update Date:2018-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60834758225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist