Healthcare Provider Details

I. General information

NPI: 1427195007
Provider Name (Legal Business Name): DENNIS C LAMASTER LMP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 10/05/2021
Certification Date: 10/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 NE BOTHELL WAY, STE 155
KENMORE WA
98028-1830
US

IV. Provider business mailing address

PO BOX 82191
KENMORE WA
98028-0191
US

V. Phone/Fax

Practice location:
  • Phone: 206-322-2620
  • Fax: 888-302-3937
Mailing address:
  • Phone: 206-322-2620
  • Fax: 888-302-3937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA 11363
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberMA11363
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: