Doctor Name: | DR. JOEL GLENN DEAN |
NPI Number: | 1568534915 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MD-13570 |
Business Practice Address: | 1400 E Kincaid St Mount Vernon, WA - 982744127 |
Business Phone Number: | 3604282586 |
Business Fax Number: | 3604286470 |
Mailing Address: | 1400 E Kincaid St, C/o Credentialing MOUNT VERNON |
State: | WA |
Postal Code: | 982744127 |
Phone Number: | 3604282500 |
Fax Number: | 3604286485 |
NPI Enumeration Date: | 11/14/2006 |
NPI Last Update Date: | 06/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD-13570 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | HI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |