Provider Demographics
NPI:1275682718
Name:BYL, DENA LYNN (LMP)
Entity Type:Individual
Prefix:MRS
First Name:DENA
Middle Name:LYNN
Last Name:BYL
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 WEST FORK RD
Mailing Address - Street 2:
Mailing Address - City:CONCONULLY
Mailing Address - State:WA
Mailing Address - Zip Code:98819
Mailing Address - Country:US
Mailing Address - Phone:509-846-1000
Mailing Address - Fax:
Practice Address - Street 1:519 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841
Practice Address - Country:US
Practice Address - Phone:509-846-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00011936174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist