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Individual

MRS. LORI CHRISTINE VAN DUSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
3801 5TH ST. SE, SUITE 220, PUYALLUP, WA 98374
(253) 445-4258
(253) 445-4724
Mailing address
11711 NE 12TH STREET, SUITE 3A, BELLEVUE, WA 98005
(425) 450-9474
(425) 635-9340

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009546
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8409393
WA
01
LI0189941
LABOR & INDUSTRIES
Enumeration date
08/02/2006
Last updated
06/25/2012
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