Healthcare Provider Details

I. General information

NPI: 1154872208
Provider Name (Legal Business Name): ERIN E STEWART DAOM, LMT, L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EVONNE NELSON LMT

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3417 EVANSTON AVE N STE 428
SEATTLE WA
98103-8970
US

IV. Provider business mailing address

5004 HUBBARD HILL RD
OAK HARBOR WA
98277-9613
US

V. Phone/Fax

Practice location:
  • Phone: 425-318-9561
  • Fax: 877-393-1378
Mailing address:
  • Phone: 425-318-9561
  • Fax: 877-393-1378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00020042
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC60716212
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: