Basic Information
Provider Information
NPI: 1003000183
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CYPHERS
FirstName: DENNIS
MiddleName: JAMES
NamePrefix: MR.
NameSuffix:  
Credential: L.M.P
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
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
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225700000XMA00024064WAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist 

ID Information
IDTypeStateIssuerDescription
CPT 9712401WALABOR & INDUSTRIESOTHER


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