Provider Demographics
NPI:1679892020
Name:HIGGINS, DAWN MARIE (DPT)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:DELAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:850 W IRONWOOD DR STE 202
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-4903
Mailing Address - Country:US
Mailing Address - Phone:208-664-2175
Mailing Address - Fax:208-664-1226
Practice Address - Street 1:1812 N LAKEWOOD DR STE 100
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2635
Practice Address - Country:US
Practice Address - Phone:208-966-4476
Practice Address - Fax:208-966-4475
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36588225100000X, 226300000X
ID8971540225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA36588OtherPHYSICAL THERAPY BOARD OF CALIFORNIA