Dykeman, Bruce
Dykeman, Bruce is an sole proprietor health care provider with primary practice located at 4423 Point Fosdick Dr Nw Suite 200, Gig Harbor WA 98335-1797. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Dykeman, Bruce can be contacted via phone (262) 909-0105.Contact Information
Primary practice address
4423 Point Fosdick Dr Nw Suite 200
Gig Harbor WA 98335-1797
Phone: (262) 909-0105
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PY00002833 | Washington |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 1485 | Wisconsin |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 71-002164 | Illinois |
Profile Details
| NPI number | 1265632244 |
|---|---|
| LBN Legal business name | Dykeman, Bruce |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 19th, 2007 |
| Last updated | May 24th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265632244 | NPPES |
| Wisconsin | Other | 1485 | WISCONSIN PSYCHOLOGIST |
| Wisconsin | Other | 71-002164 | WISCONSIN PSYCHOLOGIST |
| Wisconsin | Other | PY00002833 | WISCONSIN PSYCHOLOGIST |
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