Individual
GASTON R DEYSINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
33501 1ST WAY S, FEDERAL WAY, WA 98003-6208
(253) 838-2400
Mailing address
1100 OLIVE WAY MSC M4-PA, SEATTLE, WA 98101-1873
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD00030831
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039594
LABOR & INDUSTRY
WA
01
—
1119DE
BLUE SHIELD
WA
05
—
8268732
—
WA
01
—
MD4555W
ALASKA MEDICAID
WA
01
—
US4311896
AETNA/USHC SPECIALIST
WA
Enumeration date
07/14/2006
Last updated
01/26/2015
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