Provider Demographics
NPI:1053617357
Name:BEIERLE-BROWN, DONNA JANE (MASSAGE THERAPY)
Entity type:Individual
Prefix:MISS
First Name:DONNA
Middle Name:JANE
Last Name:BEIERLE-BROWN
Suffix:
Gender:F
Credentials:MASSAGE THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 NW HIGH ST
Mailing Address - Street 2:
Mailing Address - City:GOLDENDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98620-9280
Mailing Address - Country:US
Mailing Address - Phone:509-250-3335
Mailing Address - Fax:
Practice Address - Street 1:310 NW HIGH ST
Practice Address - Street 2:OUTCALL MASSAGE
Practice Address - City:GOLDENDALE
Practice Address - State:WA
Practice Address - Zip Code:98620-9280
Practice Address - Country:US
Practice Address - Phone:509-250-3335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60188561225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist