Provider Demographics
NPI:1932653177
Name:LIMAS, DEANNA MARIE (LMP)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:MARIE
Last Name:LIMAS
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 1:8730 TALLON LN NE
Mailing Address - Street 2:#104
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-6609
Mailing Address - Country:US
Mailing Address - Phone:360-489-0223
Mailing Address - Fax:
Practice Address - Street 1:8730 TALLON LN NE
Practice Address - Street 2:#104
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-6609
Practice Address - Country:US
Practice Address - Phone:360-489-0223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60504065225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA60504065OtherWASHINGTON DEPARTMENT OF HEALTH