Provider Demographics
NPI:1770062515
Name:DEES, CYNTHIA SNOWDEN (LMP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:SNOWDEN
Last Name:DEES
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:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:KAPOWSIN
Mailing Address - State:WA
Mailing Address - Zip Code:98344-0028
Mailing Address - Country:US
Mailing Address - Phone:253-227-1548
Mailing Address - Fax:
Practice Address - Street 1:22811 MERIDIAN AVE E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-9275
Practice Address - Country:US
Practice Address - Phone:253-227-1547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00009159225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist