David Bradley Dewine, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PY 60073200 Issued in WA

Practice address

1220 Division Ave
Tacoma, WA 98403-1321

Phone

(253) 403-1685

NPI assigned

Jul 9, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Multicare Health System

  • Family Medicine Physician
  • Kent, WA
  • NPI 1811949928
  NPD

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1144459306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 DIVISION AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984031321",
            "telephone_number": "253-403-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 DIVISION AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984031321",
            "telephone_number": "253-403-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWINE",
        "first_name": "DAVID",
        "middle_name": "BRADLEY",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-09",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY 60073200",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WA",
            "license": "PY 60073200",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WA",
            "license": "PY 60073200",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "WA",
            "license": "PY 60073200",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shatarra Devose, MA, LMHCA
• Daniel Lee Dewaelsche, M.A., MHC
• Brandy Anne Rogers Deweese, DNP
• Diana L Dewell, ARNP
• Hannah Lee Dewey Keefer, LMP
• Katherine Leslie Dewitt Williams, LMP
• Sophie Ann Dewitt
• Taylor Phan Deyoe, DO
• Kelly Jeane Deyoung, ARNP
• Lisa M Deyoung, A-GNP-C

• Clinical Child & Adolescent Psychologist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Clinical Child & Adolescent Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.