Delisa Van Dyke, L.M.T.

NPI #1174924021 in Dundee, Oregon

Provider Information

NPI Number: 1174924021
Entity Type: Individual
Name: Delisa Van Dyke, L.M.T.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: L.M.T.
Enumeration Date: Sep 10, 2014
Last Updated: Sep 23, 2014

Practice Location

Address: 940 SE LOCUST ST
City: Dundee
State: Oregon
ZIP Code: 97115-9630
Phone: (503) 915-6022

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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