Provider Demographics
NPI:1225755101
Name:SPENCER, DUSTINE (DVM)
Entity Type:Individual
Prefix:DR
First Name:DUSTINE
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:DUSTINE
Other - Middle Name:
Other - Last Name:ODLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6607 NE 84TH ST STE 109
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-2019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6607 NE 84TH ST STE 109
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-2019
Practice Address - Country:US
Practice Address - Phone:360-694-3007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22720208600000X
NV1617A208600000X
TX15868208600000X
AZ8161208600000X
WA61337407208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery