1356649073 NPI number — MRS. DEBORAH LYNN DUMONT C.T.R.S.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356649073 NPI number — MRS. DEBORAH LYNN DUMONT C.T.R.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUMONT
Provider First Name:
DEBORAH
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
C.T.R.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BECKMEYER
Provider Other First Name:
DEBORAH
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
C.T.R.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356649073
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1595
Provider Second Line Business Mailing Address:
1520 KELLY PLACE, 2ND FLOOR
Provider Business Mailing Address City Name:
WALLA WALLA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99362-0329
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-524-2920
Provider Business Mailing Address Fax Number:
509-524-2993

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1520 KELLEY PL FL 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WALLA WALLA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99362-8654
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-524-2920
Provider Business Practice Location Address Fax Number:
509-524-2993
Provider Enumeration Date:
03/03/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  CG60128428 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225800000X , with the licence number: RE00000300 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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