Healthcare Provider Details
I. General information
NPI: 1386864643
Provider Name (Legal Business Name): DEBRA D SLAPPER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
800 ALDER STREET
SOUTH BEND WA
98586
US
IV. Provider business mailing address
8512 NE SUNNYSIDE DR
VANCOUVER WA
98662-2893
US
V. Phone/Fax
- Phone: 360-875-5526
- Fax: 360-875-6167
- Phone: 360-882-6887
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | MD00043255 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | MD13255 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: