Individual
DR. DONALD FRED DEVRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1011 E MAIN AVE, SUITE 302, PUYALLUP, WA 98372-6775
(253) 841-2471
(253) 841-2472
Mailing address
1011 MAIN AVE E, STE 302, PUYALLUP, WA 98372-6775
(253) 841-2471
(253) 841-2472
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD00024699
WA
207UN0902X
Nuclear Imaging & Therapy Physician
MD00024699
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014041
LABOR & INDUSTRIES
WA
05
—
1029032
—
WA
01
—
110187011
RAILROAD MEDICARE
—
Enumeration date
04/11/2006
Last updated
07/22/2014
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