Provider Demographics
NPI:1174855431
Name:SEMU, DYLAN JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:JAMES
Last Name:SEMU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 GIRARD ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4004
Mailing Address - Country:US
Mailing Address - Phone:360-366-0907
Mailing Address - Fax:
Practice Address - Street 1:412 GIRARD ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4004
Practice Address - Country:US
Practice Address - Phone:360-734-9525
Practice Address - Fax:360-734-9505
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60134544111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor