Provider Demographics
NPI:1194811422
Name:DEVLIN, DENNIS (DC)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:DEVLIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 GRIFFIN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-2373
Mailing Address - Country:US
Mailing Address - Phone:360-825-1638
Mailing Address - Fax:360-825-7605
Practice Address - Street 1:2820 GRIFFIN AVE STE 100
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-2373
Practice Address - Country:US
Practice Address - Phone:360-825-1638
Practice Address - Fax:360-825-7605
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2080111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2003226Medicaid
WA0095091OtherDEPT OF LABOR & INDUSTRY
WA2003226Medicaid