Individual
TORE LYDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20312 42ND DR SE, BOTHELL, WA 98012-7368
(425) 402-4690
Mailing address
20312 42ND DR SE, BOTHELL, WA 98012-7368
(425) 402-4690
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/03/2012
Last updated
09/03/2012
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