Provider Demographics
NPI:1144497132
Name:BILLINGS, DEANNA (LMP)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:
Last Name:BILLINGS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3418 HARVARD DR SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-4106
Mailing Address - Country:US
Mailing Address - Phone:360-561-0171
Mailing Address - Fax:360-413-0372
Practice Address - Street 1:3418 HARVARD DR SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-4106
Practice Address - Country:US
Practice Address - Phone:360-561-0171
Practice Address - Fax:360-413-0372
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024284174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist