Provider Demographics
NPI:1356858914
Name:BYKER, MEKAELA SHIMONE (ATC)
Entity type:Individual
Prefix:
First Name:MEKAELA
Middle Name:SHIMONE
Last Name:BYKER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9843 MARKWORTH RD
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:WA
Mailing Address - Zip Code:98230-8906
Mailing Address - Country:US
Mailing Address - Phone:360-354-6854
Mailing Address - Fax:
Practice Address - Street 1:400 SEQUOIA DR STE 130
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-7634
Practice Address - Country:US
Practice Address - Phone:360-752-5551
Practice Address - Fax:360-752-0155
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA608105562255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer