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NPI Code Detail

MEDICARE: DENNY MICHAEL LAFOUNTAINE LMT

MEDICARE:   DENNY MICHAEL LAFOUNTAINE  LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMA00015416WA

General Provider Information

NPI Number : 1154148476
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNY MICHAEL LAFOUNTAINE LMT
Provider Business Mailing Address
First Line : 4803 OCEAN BEACH HWY
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-9414
Country : US
Telephone Number : 360-957-4794
Fax Number :
Provider Business Practice Location Address
First Line : 4803 OCEAN BEACH HWY
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-9414
Country : US
Telephone Number : 360-957-4794
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2024
Last Update Date : 09/26/2024

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Directions to “ DENNY MICHAEL LAFOUNTAINE LMT” Practice Location

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