Provider Demographics
NPI:1730249004
Name:CUMMINGS, DEBORAH A (LMP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:CUMMINGS
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:PO BOX 2145
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98291-2145
Mailing Address - Country:US
Mailing Address - Phone:360-563-2736
Mailing Address - Fax:360-568-6372
Practice Address - Street 1:1605 LAKE MOUNT DR
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-1730
Practice Address - Country:US
Practice Address - Phone:360-563-2736
Practice Address - Fax:360-568-6372
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00003935225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist