Individual
SALENA DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20069 STATE ROUTE 410 E, BONNEY LAKE, WA 98391-8460
(253) 447-8562
Mailing address
20069 STATE ROUTE 410 E, BONNEY LAKE, WA 98391-8460
(253) 447-8562
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC60610370
WA
Other
Enumeration date
01/18/2016
Last updated
01/18/2016
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