Provider Demographics
NPI:1245684406
Name:DOOLEY, MICHAEL J (LMT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:DOOLEY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 VALLEY MALL PKWY # 607
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-4838
Mailing Address - Country:US
Mailing Address - Phone:509-679-0841
Mailing Address - Fax:
Practice Address - Street 1:100 VALLEY MALL PKWY STE 2
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-5348
Practice Address - Country:US
Practice Address - Phone:509-679-0841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-14
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60625116225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist