Healthcare Provider Details

I. General information

NPI: 1083540603
Provider Name (Legal Business Name): DOSLYN LITTLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21806 103RD AVENUE CT E STE 103
GRAHAM WA
98338-8115
US

IV. Provider business mailing address

25353 SE RUGG RD
DAMASCUS OR
97089-8662
US

V. Phone/Fax

Practice location:
  • Phone: 253-847-3700
  • Fax:
Mailing address:
  • Phone: 253-847-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number66103
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: