Doctor Name: | MS. KERRY J DYER |
NPI Number: | 1093906901 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | EAMP, LMP, LAC |
License Number: | MA 00011217 |
Business Practice Address: | 1800 Cooks Hill Rd Suite A Centralia, WA - 985319072 |
Business Phone Number: | 3607362853 |
Business Fax Number: | 3607364159 |
Mailing Address: | 1800 Cooks Hill Rd, Suite A CENTRALIA |
State: | WA |
Postal Code: | 985319072 |
Phone Number: | 3607362853 |
Fax Number: | 3607364159 |
NPI Enumeration Date: | 08/06/2007 |
NPI Last Update Date: | 01/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA 00011217 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |