Provider Demographics
NPI:1770668576
Name:DEVNEY, ROBERT BERNARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BERNARD
Last Name:DEVNEY
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 1:19515 NORTH CREEK PKWY
Mailing Address - Street 2:STE 202
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-8200
Mailing Address - Country:US
Mailing Address - Phone:425-949-0204
Mailing Address - Fax:855-936-3250
Practice Address - Street 1:19515 NORTH CREEK PKWY
Practice Address - Street 2:STE 202
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-8200
Practice Address - Country:US
Practice Address - Phone:425-949-0204
Practice Address - Fax:855-936-3250
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000197632084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1053933Medicaid
5895OtherINTERNAL ID-MOTOR VEHICLE ID
E33385Medicare UPIN
5895OtherINTERNAL ID-MOTOR VEHICLE ID