Healthcare Provider Details

I. General information

NPI: 1043364565
Provider Name (Legal Business Name): DAWN MICHELLE CATLOW LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 PACIFIC AVENUE
TACOMA WA
98408
US

IV. Provider business mailing address

6201 PACIFIC AVENUE
TACOMA WA
98408
US

V. Phone/Fax

Practice location:
  • Phone: 253-472-9669
  • Fax: 253-473-2904
Mailing address:
  • Phone: 253-472-9669
  • Fax: 253-473-2904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00014617
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: