Provider Demographics
NPI:1356776314
Name:MCELMEEL, DAWN ELIZABETH (LMP)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:ELIZABETH
Last Name:MCELMEEL
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:E
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:10113 NE 29TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-7636
Mailing Address - Country:US
Mailing Address - Phone:503-349-2949
Mailing Address - Fax:
Practice Address - Street 1:5500 NE 109TH CT STE L
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6104
Practice Address - Country:US
Practice Address - Phone:360-828-5411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00014039225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist