Healthcare Provider Details

I. General information

NPI: 1609771880
Provider Name (Legal Business Name): DAWN RADLOFF LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 SE 131ST AVE STE 108
VANCOUVER WA
98683-4031
US

IV. Provider business mailing address

2507 NW LOGAN ST
CAMAS WA
98607-9000
US

V. Phone/Fax

Practice location:
  • Phone: 360-944-0500
  • Fax:
Mailing address:
  • Phone: 920-476-9865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number70088798
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: