Individual
MRS. ELISSA JEANE DYKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
402 15TH AVE SE STE 100, PUYALLUP, WA 98372-3709
(253) 697-5200
Mailing address
402 15TH AVE SE STE 100, PUYALLUP, WA 98372-3709
(253) 697-5200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60217771
WA
Other
Enumeration date
07/05/2011
Last updated
09/19/2011
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