Individual
DR. CORNELIS DEHART JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3436 MARY ELDER RD NE, OLYMPIA, WA 98506-5050
(360) 528-2590
Mailing address
3857 MARTIN WAY E, OLYMPIA, WA 98506-5268
(360) 704-7170
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
MD00046608
WA
Other
Enumeration date
10/19/2006
Last updated
12/03/2008
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