Provider Demographics
NPI:1265283287
Name:CAPULONG, DANA LOUISE (DO)
Entity type:Individual
Prefix:
First Name:DANA LOUISE
Middle Name:
Last Name:CAPULONG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13717 ADMIRALTY WAY UNIT L3
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-5714
Mailing Address - Country:US
Mailing Address - Phone:425-530-3317
Mailing Address - Fax:
Practice Address - Street 1:925 SENECA ST.
Practice Address - Street 2:MAILSTOP H8-GME
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101
Practice Address - Country:US
Practice Address - Phone:206-583-6079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program