Individual
MATTHEW JAY VAN DYKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
321 9TH ST, # 206, LEAVENWORTH, WA 98826-1464
(509) 630-9784
Mailing address
PO BOX 2231, LEAVENWORTH, WA 98826-2231
(509) 630-9784
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
11415
CA
171100000X
Acupuncturist
Primary
AC00002999
WA
Other
Enumeration date
01/29/2007
Last updated
07/08/2007
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