1942363106 NPI number — MRS. LOIS CHARLENE MILLS LMT , MMP

Table of content: MRS. LOIS CHARLENE MILLS LMT , MMP (NPI 1942363106)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942363106 NPI number — MRS. LOIS CHARLENE MILLS LMT , MMP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLS
Provider First Name:
LOIS
Provider Middle Name:
CHARLENE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMT , MMP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942363106
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
321 CAMERON STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAYTON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99328-1203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-382-4836
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
109 N. SECOND STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99328-1308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-382-2699
Provider Business Practice Location Address Fax Number:
509-382-2699
Provider Enumeration Date:
12/19/2006

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: 225700000X , with the licence number:  MA00003931 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: MA 00003931 . This is a "MASSAGE THERAPY LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com