Healthcare Provider Details

I. General information

NPI: 1619488673
Provider Name (Legal Business Name): DANAE TOEPPER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2017
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14313 NE 20TH AVE STE A114
VANCOUVER WA
98686-1485
US

IV. Provider business mailing address

433 SALMON CREEK RD
TOLEDO WA
98591-9616
US

V. Phone/Fax

Practice location:
  • Phone: 360-907-0772
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: