MEDICARE: STEPHANIE L DANN LMFT, ASOTP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	LF60258086	WA

General Provider Information

NPI Number	:	1124205364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE L DANN LMFT, ASOTP

Provider Business Mailing Address
First Line	:	1944 PACIFIC AVE STE 309
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98402-3121
Country	:	US
Telephone Number	:	253-880-2005
Fax Number	:	253-572-9958

Provider Business Practice Location Address
First Line	:	1944 PACIFIC AVE STE 309
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98402-3121
Country	:	US
Telephone Number	:	253-880-2005
Fax Number	:	253-572-9958

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2008
Last Update Date	:	11/07/2012

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