MEDICARE: MR. MARVIN DUANE DREESSEN DC

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
1	111N00000X	Chiropractor	788	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00913501	OTHER	WA	GROUP HEALTH
2	12646	OTHER	WA	DEPT OF L&I
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619032414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARVIN DUANE DREESSEN DC

Provider Business Mailing Address
First Line	:	2068 SE SEDGWICK ROAD
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-9502
Country	:	US
Telephone Number	:	360-876-2550
Fax Number	:	360-876-2556

Provider Business Practice Location Address
First Line	:	2068 SE SEDGWICK ROAD
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-9502
Country	:	US
Telephone Number	:	360-876-2550
Fax Number	:	360-876-2556

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	07/08/2007

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Directions to “ MR. MARVIN DUANE DREESSEN DC” Practice Location

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