Provider Demographics
NPI:1104247964
Name:PAYOPAY, DENNIS
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:PAYOPAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6004 WESTGATE BLVD # F
Mailing Address - Street 2:#220
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-2503
Mailing Address - Country:US
Mailing Address - Phone:253-759-4065
Mailing Address - Fax:866-324-6430
Practice Address - Street 1:6004 WESTGATE BLVD # F
Practice Address - Street 2:#220
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-2503
Practice Address - Country:US
Practice Address - Phone:253-759-4065
Practice Address - Fax:866-324-6430
Is Sole Proprietor?:No
Enumeration Date:2013-12-21
Last Update Date:2013-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP1 60386625225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant