Provider Demographics
NPI:1710008180
Name:BYAM, DENNIS DEWAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:DEWAYNE
Last Name:BYAM
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 1:301 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98930-1358
Mailing Address - Country:US
Mailing Address - Phone:509-882-1331
Mailing Address - Fax:509-882-2850
Practice Address - Street 1:301 DIVISION ST
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:WA
Practice Address - Zip Code:98930-1358
Practice Address - Country:US
Practice Address - Phone:509-882-1331
Practice Address - Fax:509-882-2850
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00000843111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2093201Medicaid
WAT02053Medicare UPIN