Provider Demographics
NPI:1396750725
Name:DESERTSPRING, DAVID N (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:N
Last Name:DESERTSPRING
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 1:1303 38TH AVENUE CT NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-7738
Mailing Address - Country:US
Mailing Address - Phone:253-509-8740
Mailing Address - Fax:253-509-0527
Practice Address - Street 1:1901 S. UNION AVENUE
Practice Address - Street 2:ALLENMORE HOSPITAL & MEDICAL CENTER
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405
Practice Address - Country:US
Practice Address - Phone:253-459-6611
Practice Address - Fax:253-459-6244
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT92143207L00000X
WAMD 00048897207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
050062716OtherRAILROAD MEDICARE
IL036097900Medicaid
039670OtherHEALTH ALLIANCE
G74985Medicare UPIN
IL610900/L65005Medicare PIN