Individual
DR. BRUCE DYKEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4423 POINT FOSDICK DR NW, SUITE 200, GIG HARBOR, WA 98335-1797
(262) 909-0105
Mailing address
PO BOX 1487, GIG HARBOR, WA 98335-3487
(262) 909-0105
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1485
WI
103TC0700X
Clinical Psychologist
71-002164
IL
103TC0700X
Clinical Psychologist
Primary
PY00002833
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1485
WISCONSIN PSYCHOLOGIST
WI
01
—
71-002164
ILLINOIS PSYCHOLOGIST
IL
01
—
PY00002833
WASHINGTON PSYCHOLOGIST
WA
Enumeration date
07/19/2007
Last updated
05/24/2011
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