Individual
MR. STACEY WAYNE DYKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTA
Contact information
Practice address
4560 SE INTERNATIONAL WAY, SUITE 100, CONSONUS HEALTHCARE SERVICES, MILWAUKIE, OR 97222
(971) 206-5200
(971) 206-5209
Mailing address
4560 SE INTERNATIONAL WAY, SUITE 100, CONSONUS HEALTHCARE SERVICES, MILWAUKIE, OR 97222
(971) 206-5200
(971) 206-5209
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
38
CA
Other
Enumeration date
08/05/2008
Last updated
08/05/2008
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