Provider Demographics
NPI:1710901400
Name:FIELD, DEAN A (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:A
Last Name:FIELD
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 1:4700 POINT FOSDICK DR STE 202
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1706
Mailing Address - Country:US
Mailing Address - Phone:253-858-9192
Mailing Address - Fax:253-426-6344
Practice Address - Street 1:4700 POINT FOSDICK DR STE 202
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1706
Practice Address - Country:US
Practice Address - Phone:253-858-9192
Practice Address - Fax:253-426-6344
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00038092207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA222890OtherL & I
WA249011OtherL & I
WA1045356Medicaid
WA133889OtherSTATE L&I
WA8250391Medicaid
WA0213642OtherL & I
WA0230827OtherL & I
WA0217717OtherL & I
WA0213642OtherL & I
WA133889OtherSTATE L&I
WA249011OtherL & I
WA8250391Medicaid