Organization
PUYALLUP ENDOCRINE & NUCLEAR MEDICINE CLINICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD F DEVRIES M.D. (PRESIDENT)
(253) 841-2471
Entity
Organization
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
601891662
WA
207UN0902X
Nuclear Imaging & Therapy Physician
601891662
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113381
LABOR & INDUSTRIES GROUP#
WA
05
—
7093685
—
WA
01
—
CI9058
RAILROAD MEDICARE
—
Enumeration date
04/09/2007
Last updated
07/22/2014
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