Individual
BROCK VAN DYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5919 100TH ST SW, LAKEWOOD, WA 98499-2731
(855) 223-7123
(619) 374-7134
Mailing address
PO BOX 740780, ATLANTA, GA 30374-0780
(855) 223-7123
(619) 374-7134
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
106S00000X
Behavior Technician
CBT.CB.70095888
WA
106S00000X
Behavior Technician
Primary
RBT-26-517443
WA
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/05/2020
Last updated
05/15/2026
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