MEDICARE: LYNN M DAWSON LMT

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	225700000X	Massage Therapist	2566	OR

General Provider Information

NPI Number	:	1528336492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN M DAWSON LMT

Provider Business Mailing Address
First Line	:	PO BOX 303
Second Line	:
City	:	COLUMBIA CITY
State	:	OR
Zip	:	97018-0303
Country	:	US
Telephone Number	:	503-396-0218
Fax Number	:

Provider Business Practice Location Address
First Line	:	1561 COLUMBIA BLVD
Second Line	:
City	:	SAINT HELENS
State	:	OR
Zip	:	97051-6212
Country	:	US
Telephone Number	:	503-397-0480
Fax Number	:	503-397-0790

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

Provider Enumeration Date	:	12/07/2011
Last Update Date	:	12/07/2011

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