Individual
MRS. DANA E BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2312 W MAIN ST STE 117, BATTLE GROUND, WA 98604-4233
(360) 687-7147
(360) 687-2866
Mailing address
2312 W MAIN ST STE 117, BATTLE GROUND, WA 98604-4233
(360) 687-7147
(360) 687-2866
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009536
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188232
L & I
WA
01
—
5772HI
REGENCE
WA
05
—
8405763
—
WA
01
—
PT00009536
LICENSE NUMBER
WA
Enumeration date
12/08/2006
Last updated
03/08/2022
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