Provider Demographics
NPI:1669801015
Name:DYCK, DENNIS (PHD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:DYCK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9116 E SPRAGUE AVE # 540
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4397
Mailing Address - Country:US
Mailing Address - Phone:509-475-9924
Mailing Address - Fax:877-992-7014
Practice Address - Street 1:1415 S RIEGEL CT
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-3242
Practice Address - Country:US
Practice Address - Phone:509-475-9924
Practice Address - Fax:877-992-7014
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001596103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical