Yvonne Joann Dixon, LMP

Individual provider Active NPI Massage Therapist · Othello, WA

NPI 1407196629 · NPPES record last updated Feb 25, 2013

Key facts

NPI
1407196629
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA 00021096 (WA)
Practice address
15279 Road D SE
Othello, WA 99344-8105
Phone
(509) 750-0900
NPI assigned
Feb 25, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MA 00021096WAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA 00021096 WA Yes

Addresses

Primary practice location

15279 Road D SE
Othello, WA 99344-8105

Mailing address

15279 Road D SE
Othello, WA 99344-8105
Phone (509) 750-0900

Other providers in Othello, WA

All providers in Othello, WA · Massage Therapist in Washington

Sources for this page

Verify at the official NPI Registry.