Provider Demographics
NPI:1871087486
Name:DUMAR, KINDRA NADINE (LMT)
Entity type:Individual
Prefix:MRS
First Name:KINDRA
Middle Name:NADINE
Last Name:DUMAR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 CAPITAL MALL DR SW APT J202
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-8670
Mailing Address - Country:US
Mailing Address - Phone:360-350-8284
Mailing Address - Fax:
Practice Address - Street 1:1210 SLEATER KINNEY RD SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-2316
Practice Address - Country:US
Practice Address - Phone:360-352-4511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024432225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist