Provider Demographics
NPI:1689167108
Name:MCFERON, DEVIN THOMAS (LMT)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:THOMAS
Last Name:MCFERON
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2923 NE 199TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-1453
Mailing Address - Country:US
Mailing Address - Phone:206-365-0643
Mailing Address - Fax:
Practice Address - Street 1:10021 HOLMAN RD NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98177-4920
Practice Address - Country:US
Practice Address - Phone:206-632-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-09
Last Update Date:2018-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60823982225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist