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NPI Code Detail

MEDICARE: CHERIE DUBEAU LMP

MEDICARE:   CHERIE  DUBEAU  LMP
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
1225700000XMassage TherapistMA 60146601WA

General Provider Information

NPI Number : 1679890982
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERIE DUBEAU LMP
Provider Business Mailing Address
First Line : 4406 W LAKE SAMMAMISH PKWY SE
Second Line :
City : ISSAQUAH
State : WA
Zip : 98027-9774
Country : US
Telephone Number : 360-941-1615
Fax Number : 425-643-9170
Provider Business Practice Location Address
First Line : 4406 W LAKE SAMMAMISH PKWY SE
Second Line :
City : ISSAQUAH
State : WA
Zip : 98027-9774
Country : US
Telephone Number : 360-941-1615
Fax Number : 425-643-9170
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2010
Last Update Date : 04/26/2010

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Directions to “ CHERIE DUBEAU LMP” Practice Location

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