Provider Demographics
NPI:1740685866
Name:BERARDINELLI, DANELLE
Entity type:Individual
Prefix:MRS
First Name:DANELLE
Middle Name:
Last Name:BERARDINELLI
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DANELLE
Other - Middle Name:
Other - Last Name:BERARDINELLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMP
Mailing Address - Street 1:8800 ST HELENS AVE
Mailing Address - Street 2:NONE
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-2646
Mailing Address - Country:US
Mailing Address - Phone:360-909-7882
Mailing Address - Fax:
Practice Address - Street 1:8800 ST HELENS AVE
Practice Address - Street 2:NONE
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-2646
Practice Address - Country:US
Practice Address - Phone:360-909-7882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023654225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist