Provider Demographics
NPI:1336389949
Name:FISHER-DORSEY, KERI J (LMP)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:J
Last Name:FISHER-DORSEY
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 1:1327 E ROWAN AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-3435
Mailing Address - Country:US
Mailing Address - Phone:509-217-5560
Mailing Address - Fax:509-217-5560
Practice Address - Street 1:1327 E ROWAN AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-3435
Practice Address - Country:US
Practice Address - Phone:509-217-5560
Practice Address - Fax:509-217-5560
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60034992225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist