Provider Demographics
NPI:1750412557
Name:AMMONS, DEBORAH L (LMP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:AMMONS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:L
Other - Last Name:AMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:324 S. CHELAN AVE.
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801
Mailing Address - Country:US
Mailing Address - Phone:509-670-7777
Mailing Address - Fax:
Practice Address - Street 1:324 S. CHELAN AVE.
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801
Practice Address - Country:US
Practice Address - Phone:509-670-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016799174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist