Provider Demographics
NPI:1558544809
Name:DIXON, VALERIE JEAN (RPT)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:JEAN
Last Name:DIXON
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10711 E BIG MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:CHATTAROY
Mailing Address - State:WA
Mailing Address - Zip Code:99003-9516
Mailing Address - Country:US
Mailing Address - Phone:509-238-4667
Mailing Address - Fax:
Practice Address - Street 1:10711 E BIG MEADOWS RD
Practice Address - Street 2:
Practice Address - City:CHATTAROY
Practice Address - State:WA
Practice Address - Zip Code:99003-9516
Practice Address - Country:US
Practice Address - Phone:509-238-4667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003313225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist