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NPI Code Detail

MEDICARE: DONI A TOBOLA LMP

MEDICARE:   DONI A TOBOLA  LMP
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 TherapistMA 6279WA

General Provider Information

NPI Number : 1871636027
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONI A TOBOLA LMP
Provider Business Mailing Address
First Line : 2721 208TH AVE E
Second Line :
City : LAKE TAPPS
State : WA
Zip : 98391-9026
Country : US
Telephone Number : 253-862-7226
Fax Number : 253-862-7226
Provider Business Practice Location Address
First Line : 2721 208TH AVE E
Second Line :
City : LAKE TAPPS
State : WA
Zip : 98391-9026
Country : US
Telephone Number : 253-862-7226
Fax Number : 253-862-7226
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2007
Last Update Date : 07/08/2007

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Directions to “ DONI A TOBOLA LMP” Practice Location

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