Individual
DANIEL DEVELDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
901 MT VIEW DR, SHELTON, WA 98584-4401
(360) 426-1611
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3630
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
AP30005186
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN00082710
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9624859
—
WA
01
—
DE3509
BLUE CROSS OF WA
WA
Enumeration date
04/03/2006
Last updated
12/16/2011
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