Healthcare Provider Details

I. General information

NPI: 1801168950
Provider Name (Legal Business Name): DEVLYN JONES NEVEUX PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2012
Last Update Date: 03/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16811 SE MCGILLIVRAY BLVD
VANCOUVER WA
98683-3404
US

IV. Provider business mailing address

15311 NE 179TH CIR
BRUSH PRAIRIE WA
98606-7317
US

V. Phone/Fax

Practice location:
  • Phone: 360-735-8100
  • Fax: 360-253-1781
Mailing address:
  • Phone: 360-975-1962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA10002378
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: