Individual
DYLAN REVERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4220 80TH ST NE, MARYSVILLE, WA 98270-3423
(360) 965-0000
Mailing address
20120 47TH AVE NE, LAKE FOREST PARK, WA 98155-1740
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLPI.SI.70024648
WA
Other
Enumeration date
10/10/2025
Last updated
10/10/2025
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