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General NPI Number Information
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NPI Number | 1073632295
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Entity Type | Individual
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Provider Name | DIANNE M DELREYES LAC.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 800 FRANKLIN ST SUITE 204
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City | VANCOUVER
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State | WA
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Zip | 98660-3355
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Country | US
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Telephone | 360-693-7505
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Fax |
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Provider Business Mailing Address
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Address Line | 412 W 24TH ST
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City | VANCOUVER
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State | WA
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Zip | 98660-2531
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Country | US
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Telephone | 503-515-7043
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC00002221
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License Number State | WA
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