Provider Demographics
NPI:1730540733
Name:DEARMIN, ELIZABETH MORGAN (LMP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MORGAN
Last Name:DEARMIN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15619 NE CAPLES RD
Mailing Address - Street 2:#34
Mailing Address - City:BRUSH PRAIRIE
Mailing Address - State:WA
Mailing Address - Zip Code:98606-9526
Mailing Address - Country:US
Mailing Address - Phone:360-558-8166
Mailing Address - Fax:
Practice Address - Street 1:601 MAIN ST STE AND210
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3402
Practice Address - Country:US
Practice Address - Phone:360-558-8166
Practice Address - Fax:360-583-3523
Is Sole Proprietor?:No
Enumeration Date:2016-03-18
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60607987225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist