Basic Information
| Provider Information | |||||||||
| NPI: | 1003000183 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CYPHERS | ||||||||
| FirstName: | DENNIS | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | L.M.P | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6930 52ND AVE W | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984673207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2532284434 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6930 52ND AVE W | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984673207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2532284434 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2007 | ||||||||
| LastUpdateDate: | 08/30/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | MA00024064 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
ID Information
| ID | Type | State | Issuer | Description | CPT 97124 | 01 | WA | LABOR & INDUSTRIES | OTHER |