Provider Demographics
NPI:1396870754
Name:LUTH, DANA GERMAINE (LMP CMT)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:GERMAINE
Last Name:LUTH
Suffix:
Gender:F
Credentials:LMP CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 E. ROWAN
Mailing Address - Street 2:SUITE L5
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207
Mailing Address - Country:US
Mailing Address - Phone:509-979-3099
Mailing Address - Fax:
Practice Address - Street 1:12 E. ROWAN
Practice Address - Street 2:SUITE L5
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207
Practice Address - Country:US
Practice Address - Phone:509-979-3099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023066225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist