Individual
SEAN O DAHLSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9307 BRIDGEPORT WAY SW, LAKEWOOD, WA 98499-1570
(253) 201-1234
Mailing address
102 1ST AVE W, SISSETON, SD 57262-1922
(970) 506-4729
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OC61409258
WA
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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