Provider Demographics
NPI:1851518567
Name:DAWIT, PROMISE (LMP)
Entity Type:Individual
Prefix:
First Name:PROMISE
Middle Name:
Last Name:DAWIT
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 1:1823 E MADISON ST APT B404
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-7513
Mailing Address - Country:US
Mailing Address - Phone:206-816-2814
Mailing Address - Fax:206-329-4231
Practice Address - Street 1:609 10TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-5019
Practice Address - Country:US
Practice Address - Phone:206-816-2814
Practice Address - Fax:206-329-4231
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022529225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist