Provider Demographics
NPI:1861179145
Name:MARSTELLER, DANA CAMILLE (IBCLC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:CAMILLE
Last Name:MARSTELLER
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 E 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2310
Mailing Address - Country:US
Mailing Address - Phone:949-813-3933
Mailing Address - Fax:
Practice Address - Street 1:501 S BERNARD ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2511
Practice Address - Country:US
Practice Address - Phone:509-701-7651
Practice Address - Fax:509-279-2636
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAL-310877174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN