Provider Demographics
NPI:1225364540
Name:GROVE, DEAN ALLEN (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:ALLEN
Last Name:GROVE
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-4248
Mailing Address - Country:US
Mailing Address - Phone:425-641-3755
Mailing Address - Fax:425-641-5155
Practice Address - Street 1:5425 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-4248
Practice Address - Country:US
Practice Address - Phone:425-641-3755
Practice Address - Fax:425-641-5155
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 000173862083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine