Deborah Rae Dehaven, REGISTERED DIETITIAN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI654 Issued in WA

Practice address

17700 SE 272ND St Ste 300
Covington, WA 98042-4951

Phone

(253) 372-7011

NPI assigned

Nov 21, 2017

Last updated

Nov 21, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Deborah Rae McMillan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1053825422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 S UNION AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17700 SE 272ND ST STE 300",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980424951",
            "telephone_number": "253-372-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAVEN",
        "first_name": "DEBORAH",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED DIETITIAN",
            "identifier": "DI654",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "MCMILLAN",
            "middle_name": "RAE",
            "prefix": "MISS",
            "credential": "REGISTERED DIETITIAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Lee DDS PLLC (Covington Smiles)
• Edwardo Romero Daniel, RPH
• Shiyana Daniels
• Jamie Davies Rochman, PHARMD
• Maricar Deguzman-Abajero, MD
• Colleen K Deveraux, LMP
• Dhaliwal and Dhaliwal DDS, PLLC
• Delia Diaz, BA, RBT, CBT
• Liam T Diesing, DPT
• Christine DO, D.D.S

• Registered Dietitian in Covington, WA
• Providers in Covington, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.