| Doctor Name: | MR. JEFFREY WILLIAM DYER |
| NPI Number: | 1023127289 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CLINICIAN I |
| License Number: | RC00039751 |
| Business Practice Address: | 1900 N 30th St Mount Vernon, WA - 982738914 |
| Business Phone Number: | 3604193544 |
| Business Fax Number: | 3604193505 |
| Mailing Address: | 1900 N 30th St, MOUNT VERNON |
| State: | WA |
| Postal Code: | 982738914 |
| Phone Number: | 3604193544 |
| Fax Number: | 3604193505 |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | RC00039751 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |