Provider Demographics
NPI:1902285794
Name:SLONE, DELANA
Entity Type:Individual
Prefix:
First Name:DELANA
Middle Name:
Last Name:SLONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:SKYKOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98288-0127
Mailing Address - Country:US
Mailing Address - Phone:425-760-4154
Mailing Address - Fax:
Practice Address - Street 1:104 RAILROAD AVENUE WEST
Practice Address - Street 2:
Practice Address - City:SKYKOMISH
Practice Address - State:WA
Practice Address - Zip Code:98288
Practice Address - Country:US
Practice Address - Phone:425-760-4154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-26
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARF60486948173C00000X
TXMT027595225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist