Provider Demographics
NPI:1427348606
Name:RICHARDSON, DOLLY ANN (LMT)
Entity type:Individual
Prefix:MRS
First Name:DOLLY
Middle Name:ANN
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:LMT
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Mailing Address - Street 1:505 E TWIN FALLS ST
Mailing Address - Street 2:PO BOX 281
Mailing Address - City:YACOLT
Mailing Address - State:WA
Mailing Address - Zip Code:98675-5576
Mailing Address - Country:US
Mailing Address - Phone:360-524-1420
Mailing Address - Fax:
Practice Address - Street 1:6700 NE 162ND AVE
Practice Address - Street 2:SUITE 415
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-3858
Practice Address - Country:US
Practice Address - Phone:360-882-0767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2012-03-20
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist