Individual
JONATHAN DYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4545 41ST AVE SW, SEATTLE, WA 98116-4220
(206) 932-8363
(206) 932-4973
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60483817
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2041647
—
WA
01
—
P01582591
RR MEDICARE
WA
Enumeration date
11/18/2014
Last updated
02/23/2016
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