Provider Demographics
NPI:1255653358
Name:DOWREY, DENNIS WAYNE (IDC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:WAYNE
Last Name:DOWREY
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9154 GRAVELLY LN SW
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367
Mailing Address - Country:US
Mailing Address - Phone:360-265-6047
Mailing Address - Fax:
Practice Address - Street 1:7111 SEALION RD
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98315-7102
Practice Address - Country:US
Practice Address - Phone:360-315-4166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman