Provider Demographics
NPI:1598801912
Name:MORGAN, YARROW DIANNA (LMP)
Entity type:Individual
Prefix:
First Name:YARROW
Middle Name:DIANNA
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3340 LADY FERN LOOP NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-3287
Mailing Address - Country:US
Mailing Address - Phone:360-402-1589
Mailing Address - Fax:360-357-3080
Practice Address - Street 1:509 12TH AVE SE
Practice Address - Street 2:SUITE 20
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-7514
Practice Address - Country:US
Practice Address - Phone:360-402-1589
Practice Address - Fax:360-357-3080
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00006430225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist