Provider Demographics
NPI:1225841000
Name:DALMACIO, JUSTIN ALLAN (DPT)
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:ALLAN
Last Name:DALMACIO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9989 BARNSTON DR E
Mailing Address - Street 2:#75
Mailing Address - City:SURREY
Mailing Address - State:BRITISH COLUMBIA
Mailing Address - Zip Code:V4N6N3
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8125 BIRCH BAY SQUARE ST STE 248
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:WA
Practice Address - Zip Code:98230-9847
Practice Address - Country:US
Practice Address - Phone:360-366-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61620758225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist