MEDICARE: DONI A TOBOLA 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
1	225700000X	Massage Therapist	MA 6279	WA

General Provider Information

NPI Number	:	1871636027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONI A TOBOLA LMP

Provider Business Mailing Address
First Line	:	2721 208TH AVE E
Second Line	:
City	:	LAKE TAPPS
State	:	WA
Zip	:	98391-9026
Country	:	US
Telephone Number	:	253-862-7226
Fax Number	:	253-862-7226

Provider Business Practice Location Address
First Line	:	2721 208TH AVE E
Second Line	:
City	:	LAKE TAPPS
State	:	WA
Zip	:	98391-9026
Country	:	US
Telephone Number	:	253-862-7226
Fax Number	:	253-862-7226

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

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	07/08/2007

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Directions to “ DONI A TOBOLA LMP” Practice Location

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