MEDICARE: DARREN G DILLEY PT

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	225100000X	Physical Therapist	10469	WI

General Provider Information

NPI Number	:	1225173792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARREN G DILLEY PT

Provider Business Mailing Address
First Line	:	4100 SW 109TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98146-1654
Country	:	US
Telephone Number	:	414-581-2295
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 SW 109TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98146-1654
Country	:	US
Telephone Number	:	414-581-2295
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	01/27/2021

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