Provider Demographics
NPI:1932283165
Name:DALTON, ISABELLE BERNADETTE (LMP, PHD)
Entity Type:Individual
Prefix:
First Name:ISABELLE
Middle Name:BERNADETTE
Last Name:DALTON
Suffix:
Gender:F
Credentials:LMP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 39TH AVE SW STE F
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-3692
Mailing Address - Country:US
Mailing Address - Phone:253-221-7374
Mailing Address - Fax:253-848-5533
Practice Address - Street 1:803 39TH AVE SW STE F
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-3692
Practice Address - Country:US
Practice Address - Phone:253-221-7374
Practice Address - Fax:253-848-5533
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA19841225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist