Provider Demographics
NPI:1962949644
Name:PHELPS, DANYA LEE (LMP)
Entity type:Individual
Prefix:
First Name:DANYA
Middle Name:LEE
Last Name:PHELPS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:DANYA
Other - Middle Name:LEE
Other - Last Name:LINDLEY SINNOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5218 W GARDEN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-5324
Mailing Address - Country:US
Mailing Address - Phone:509-954-9385
Mailing Address - Fax:
Practice Address - Street 1:820 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2809
Practice Address - Country:US
Practice Address - Phone:509-954-9385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60716102225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist