Provider Demographics
NPI:1427599661
Name:PICOZZI, DEAN (MLP)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:
Last Name:PICOZZI
Suffix:
Gender:M
Credentials:MLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8451 W MERCER WAY
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-5632
Mailing Address - Country:US
Mailing Address - Phone:206-679-2077
Mailing Address - Fax:
Practice Address - Street 1:8451 W MERCER WAY
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-5632
Practice Address - Country:US
Practice Address - Phone:206-679-2077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60715805225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist