Most Relevant Information
Provider Data
| NPI Number: | 1003477761 |
| Provider Name: | DOMINIQUE DEVINE LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | MA60973322 |
Most Important Dates
| Enumeration Date: | 06/24/2019 |
| Last Updated: | 06/24/2019 |
Provider Practice Location
1450 5TH ST SE STE 4400
PUYALLUP
WA
983724691
Practice Location Phone/Fax
| Phone: | 2538811362 |
| Fax: | 2538811368 |
Provider Mailing Location
6050 TACOMA MALL BLVD STE 300
TACOMA
WA
984096828
Provider Mailing Phone/Fax
| Phone: | 2535815200 |
| Fax: | 2535815203 |