Dustine Spencer, DVM

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

61337407 Issued in WA

Practice address

6607 NE 84TH St Ste 109
Vancouver, WA 98665-2019

Phone

(360) 694-3007

NPI assigned

Oct 21, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other names 1

• Dustine Odle Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Blue Pearl Vancouver

  • Specialist
  • Vancouver, WA
  • NPI 1043769334
  NPD (past)

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1225755101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6607 NE 84TH ST STE 109",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986652019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6607 NE 84TH ST STE 109",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986652019",
            "telephone_number": "360-694-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "DUSTINE",
        "name_prefix": "Dr.",
        "credential": "DVM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "22720",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "1617A",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "15868",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "8161",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "61337407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DUSTINE",
            "last_name": "ODLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Special Delivery Dental Care, PLLC
• Specialty Athletic Training
• Spectrum Mental Health
• Speech and Language Connections
• Aryiana Rochelle Spencer
• Jeanette Michelle Spencer, CPC
• Stacey Spencer, LICSWA
• Julie A Sperry, LMP
• Jennifer Spiker, RN
• John C Spitler, PA-C

• Surgery Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; 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.