MEDICARE: DENA BYL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA00011936	WA

General Provider Information

NPI Number	:	1629323316
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENA BYL

Provider Business Mailing Address
First Line	:	670 RIVERSIDE DRIVE
Second Line	:
City	:	OMAK
State	:	WA
Zip	:	98841-1438
Country	:	US
Telephone Number	:	509-846-1000
Fax Number	:	509-846-1005

Provider Business Practice Location Address
First Line	:	670 RIVERSIDE
Second Line	:
City	:	OMAK
State	:	WA
Zip	:	98841-1438
Country	:	US
Telephone Number	:	509-846-1000
Fax Number	:	509-846-1005

Authorized Official
Title or Position	:	OWNER/MASSAGE THERAPIST
Name	:	DENA BYL
Credential	:
Telephone Number	:	509-846-1000

Provider Enumeration Date	:	07/18/2012
Last Update Date	:	07/18/2012

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Directions to “DENA BYL ” Practice Location

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