Provider Demographics
NPI:1295862159
Name:GALVON, DENNIS J (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:J
Last Name:GALVON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4423 PT FOSDICK DR NW STE 212
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1794
Mailing Address - Country:US
Mailing Address - Phone:253-851-8545
Mailing Address - Fax:253-851-8644
Practice Address - Street 1:4423 POINT FOSDICK NWDR 212
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1794
Practice Address - Country:US
Practice Address - Phone:253-851-8545
Practice Address - Fax:253-851-8644
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00041644207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7367234OtherAETNA
WAMD00041644OtherMEDICAL LICENSE NUMBER
WAMD00041644OtherMEDICAL LICENSE NUMBER
WAG63506Medicare UPIN