Provider Demographics
NPI:1992143655
Name:DESCHENES, DAVID R (PT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:DESCHENES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4218
Mailing Address - Country:US
Mailing Address - Phone:360-933-1405
Mailing Address - Fax:360-392-8248
Practice Address - Street 1:2004 N STATE ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4218
Practice Address - Country:US
Practice Address - Phone:360-933-1405
Practice Address - Fax:360-392-8248
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP160132476225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant