Provider Demographics
NPI:1013987262
Name:DEWEBER, KEVIN (MD, FAMSSM, FAAFP)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:DEWEBER
Suffix:
Gender:M
Credentials:MD, FAMSSM, FAAFP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FAMILY MEDICINE OF SW WASHINGTON
Mailing Address - Street 2:100 EAST 33RD STREET SUITE 100
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663
Mailing Address - Country:US
Mailing Address - Phone:360-514-7550
Mailing Address - Fax:360-514-7484
Practice Address - Street 1:100 E. 33RD STREET
Practice Address - Street 2:FAMILY MEDICINE OF SW WASHINGTON
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663
Practice Address - Country:US
Practice Address - Phone:360-514-7550
Practice Address - Fax:360-514-7494
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60291290207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine