Individual
MR. DAVID LEE DELISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-4587
(253) 477-3818
Mailing address
MAMC BLDG 9925D, EAST JOHNSON STREET OLD MADIGAN, TACOMA, WA 98431-0001
(253) 968-4587
(253) 986-1404
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10003861
WA
363AM0700X
Medical Physician Assistant
Primary
PA10003861
WA
Other
Enumeration date
01/30/2007
Last updated
08/02/2019
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