Provider Demographics
NPI:1790981751
Name:MUSFELDT, DEANNA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:MARIE
Last Name:MUSFELDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEANNA
Other - Middle Name:
Other - Last Name:KLESNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9040 JACKSON AVE
Mailing Address - Street 2:MAMC, SECOND FLOOR, ICU
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE
Practice Address - Street 2:MAMC, SECOND FLOOR, ICU
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-968-1510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD14179207P00000X
TXN5783207P00000X
WAMD60588908207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine