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Individual

HENRY L DEGIVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3516 12TH AVE NE, OLYMPIA, WA 98506-5218
(360) 918-0604
(360) 456-6504
Mailing address
3516 12TH AVE NE, OLYMPIA, WA 98506-5218
(360) 918-0604
(360) 456-6504

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00017990
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1002662
WA
Enumeration date
10/04/2006
Last updated
04/21/2016
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