Healthcare Provider Details

I. General information

NPI: 1225558901
Provider Name (Legal Business Name): DAWNELL TOKARCHUK PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2017
Last Update Date: 06/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 E DIVISION ST
MOUNT VERNON WA
98274-4639
US

IV. Provider business mailing address

609 RUBY PEAK AVE
MOUNT VERNON WA
98273-8922
US

V. Phone/Fax

Practice location:
  • Phone: 425-387-2836
  • Fax:
Mailing address:
  • Phone: 425-387-2836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: