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NPI Code Detail

MEDICARE: DR. DAVID J. PERRY PHD

MEDICARE: DR. DAVID J. PERRY PHD
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
1103T00000XPsychologistPY00001729WA

General Provider Information

NPI Number : 1912955998
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID J. PERRY PHD
Provider Business Mailing Address
First Line : PO BOX 3025
Second Line :
City : YELM
State : WA
Zip : 98597-3025
Country : US
Telephone Number : 360-894-1759
Fax Number : 360-894-1759
Provider Business Practice Location Address
First Line : 6212 75TH ST W
Second Line :
City : LAKEWOOD
State : WA
Zip : 98499-8368
Country : US
Telephone Number : 253-588-0580
Fax Number : 253-588-0580
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 12/27/2007

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Directions to “ DR. DAVID J. PERRY PHD” Practice Location

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