Provider Demographics
NPI:1801932298
Name:STEINECKER, DEVORAH G (DO)
Entity type:Individual
Prefix:DR
First Name:DEVORAH
Middle Name:G
Last Name:STEINECKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:DOREEN
Other - Middle Name:H
Other - Last Name:STEINECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 15138
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-0138
Mailing Address - Country:US
Mailing Address - Phone:206-523-5437
Mailing Address - Fax:206-285-0821
Practice Address - Street 1:557 ROY ST STE 100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4288
Practice Address - Country:US
Practice Address - Phone:206-523-5437
Practice Address - Fax:206-285-0821
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA025207 OP00001062204D00000X
WAOP 0010622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1028687Medicaid
WA025207 OP00001062OtherMEDICAL LICENSE #
WA025207 OP00001062OtherMEDICAL LICENSE #
WAD72503Medicare UPIN