Individual
ANDREW PETER DERVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-6008
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD60391410
WA
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
MD60391410
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851690614
—
WA
Enumeration date
03/19/2011
Last updated
10/02/2018
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