Provider Demographics
NPI:1679733638
Name:FISCHER, DANA MARIE (MA00024010)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:MARIE
Last Name:FISCHER
Suffix:
Gender:F
Credentials:MA00024010
Other - Prefix:MRS
Other - First Name:DANA
Other - Middle Name:MARIE
Other - Last Name:OVERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA00024010
Mailing Address - Street 1:1616 12TH ST
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-2113
Mailing Address - Country:US
Mailing Address - Phone:360-770-6718
Mailing Address - Fax:866-234-9871
Practice Address - Street 1:2216 COMMERCIAL AVE.
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221
Practice Address - Country:US
Practice Address - Phone:360-293-0299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024010174400000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No174400000XOther Service ProvidersSpecialist