Healthcare Provider Details

I. General information

NPI: 1861438558
Provider Name (Legal Business Name): DAVID W DEMPSTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 MARTIN LUTHER KING JR WAY GROUP HEALTH SPECIALTY CENTER
TACOMA WA
98405-4265
US

IV. Provider business mailing address

209 MARTIN LUTHER KING JR WAY TACOMA MEDICAL CENTER
TACOMA WA
98405-5093
US

V. Phone/Fax

Practice location:
  • Phone: 253-596-3444
  • Fax:
Mailing address:
  • Phone: 253-596-3300
  • Fax: 253-596-3301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD00040610
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD00040610
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: