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Individual

DAVID NERSETH IRVINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1809 MAPLE ST, FOREST GROVE, OR 97116-1939
(503) 357-2173
(503) 357-2318
Mailing address
505 S 336TH ST, SUITE 600, FEDERAL WAY, WA 98003-6328
(253) 838-6180
(253) 838-6418

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD15519
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0216865
LIWA
WA
05
059253
OR
01
6751HU
BSWA
WA
05
8240871
WA
01
8946238
VCR
WA
Enumeration date
06/10/2006
Last updated
02/29/2008
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