Provider Demographics
NPI:1922340850
Name:DUMAS, SHAUN LEE (LAC)
Entity Type:Individual
Prefix:
First Name:SHAUN
Middle Name:LEE
Last Name:DUMAS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 KING PARK DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6257
Mailing Address - Country:US
Mailing Address - Phone:406-652-4098
Mailing Address - Fax:406-655-4944
Practice Address - Street 1:670 KING PARK DR
Practice Address - Street 2:SUITE 1
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6257
Practice Address - Country:US
Practice Address - Phone:406-652-4098
Practice Address - Fax:406-655-4944
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT21186171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist