Provider Demographics
NPI:1992817001
Name:DESCHENES, DAVID S (OT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:DESCHENES
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 MADISON ST
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1172
Mailing Address - Country:US
Mailing Address - Phone:206-264-8100
Mailing Address - Fax:206-264-8689
Practice Address - Street 1:1401 S LAVENTURE RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-6033
Practice Address - Country:US
Practice Address - Phone:360-424-2400
Practice Address - Fax:360-424-2418
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001264225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0222959OtherDEPARTMENT OF L&I
WAR10001OtherREGENCE BLUE SHIELD
WA0222958OtherDEPARTMENT OF L&I
WA9115DEOtherREGENCE/BLUE SHIELD
WA7073209OtherAETNA
WA8487928OtherDSHS
WA72843OtherLABOR & INDUSTRIES
WA8944931OtherL&I CRIME VICTIMS
WA7728DEOtherREGENCE/BLUE SHIELD
WA7680465Medicaid
WA72843OtherLABOR & INDUSTRIES
WA9115DEOtherREGENCE/BLUE SHIELD