Provider Demographics
NPI:1346487873
Name:FISHER, DEVIN COURTNEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:COURTNEY
Last Name:FISHER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 818
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-0818
Mailing Address - Country:US
Mailing Address - Phone:360-876-0445
Mailing Address - Fax:360-876-0447
Practice Address - Street 1:2021 SE SEDGWICK RD
Practice Address - Street 2:SUITE #3
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-9502
Practice Address - Country:US
Practice Address - Phone:360-876-0445
Practice Address - Fax:360-876-0447
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 600415921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice