Individual
DONOVAN PAUL LOOMIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
3601 FREMONT AVE N STE 412, SEATTLE, WA 98103-8753
(206) 853-1540
(206) 853-1540
Mailing address
14912 N PARK AVE N, SHORELINE, WA 98133-6521
(206) 291-3149
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60732442
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA60732442
DEPARTMENT OF HEALTH
WA
Enumeration date
05/30/2017
Last updated
05/30/2017
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