Provider Demographics
NPI:1992268536
Name:RINALDINI, DYLAN BURKE
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:BURKE
Last Name:RINALDINI
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 1:1445 NE N FAIRWAY DR APT M55
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-5073
Mailing Address - Country:US
Mailing Address - Phone:707-799-5003
Mailing Address - Fax:
Practice Address - Street 1:1445 NE N FAIRWAY DR APT M55
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5073
Practice Address - Country:US
Practice Address - Phone:707-799-5003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer