Provider Demographics
NPI:1457986713
Name:MCDERMOTT, DEVIN ANNE (LAC)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:ANNE
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W OLYMPIC PL APT 208
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-4758
Mailing Address - Country:US
Mailing Address - Phone:206-300-2220
Mailing Address - Fax:
Practice Address - Street 1:201 W OLYMPIC PL APT 208
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-4758
Practice Address - Country:US
Practice Address - Phone:206-300-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60998235171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist