Provider Demographics
NPI:1457508582
Name:BANK, DEVON RENIERS (PNP)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:RENIERS
Last Name:BANK
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:DEVON
Other - Middle Name:KENNEDY
Other - Last Name:RENIERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7724 E GREEN LAKE DR N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-4967
Mailing Address - Country:US
Mailing Address - Phone:214-456-5059
Mailing Address - Fax:
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:M/S W-9824
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-3963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60301810363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics