Individual
JOHN S. DEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
819 S. 13TH STREET, MOUNT VERNON, WA 98274-4127
(360) 814-6230
(360) 814-6240
Mailing address
1400 E KINCAID ST, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
5101010625
MI
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
OP60640808
WA
207Q00000X
Family Medicine Physician
5101010625
MI
207Q00000X
Family Medicine Physician
Primary
OP60640808
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08-5-41-0248-5
BCBS PIN
MI
05
—
1740244193
—
MI
Enumeration date
04/13/2006
Last updated
06/07/2016
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