Provider Demographics
NPI:1679306054
Name:DOWD, SAMANTHA K (LMT)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:K
Last Name:DOWD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1150 S COLONY WAY
Mailing Address - Street 2:STE 3 PMB 423
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645
Mailing Address - Country:US
Mailing Address - Phone:907-841-8894
Mailing Address - Fax:
Practice Address - Street 1:1261 S SEWARD MERIDIAN PKWY STE F
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-8372
Practice Address - Country:US
Practice Address - Phone:907-357-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-22
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK219557225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist