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NPI Code Detail

MEDICARE: DEVON SPENCER

MEDICARE:   DEVON  SPENCER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770050411
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEVON SPENCER
Provider Business Mailing Address
First Line : 2100 24TH AVE S STE 260
Second Line :
City : SEATTLE
State : WA
Zip : 98144-4644
Country : US
Telephone Number : 206-795-6540
Fax Number : 206-382-4967
Provider Business Practice Location Address
First Line : 2100 24TH AVE S STE 260
Second Line :
City : SEATTLE
State : WA
Zip : 98144-4644
Country : US
Telephone Number : 206-795-6540
Fax Number : 206-382-4967
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2018
Last Update Date : 12/04/2018

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Directions to “ DEVON SPENCER ” Practice Location

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