Individual provider Active NPI

Victoria Devere, DO

  • Pediatrics Physician
  • Puyallup, WA
National Provider Identifier
1295363828
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OP61396308 Issued in WA
Practice address
1700 5TH St SE
Puyallup, WA 98372-4652
Phone
(253) 848-8797
NPI assigned
Mar 30, 2020
Last updated
Jul 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X OP61396308 WA Primary
Pediatrics Physician 208000000X 76398-21 WI

Addresses

Primary practice location

1700 5TH St SE
Puyallup, WA 98372-4652

Mailing address

1700 5TH St SE Ste 101
Puyallup, WA 98372-4684
Phone (253) 848-8797

Other practice location 1

999 N 92nd St Ste 730
Milwaukee, WI 53226-4875
Phone (414) 266-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240116004022 WA Practitioner - Pediatric Medicine 2264825348 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
OP61396308WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Oct 16, 2023 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Oct 16, 2023 Accepting new patients
Multicare Health System Past Accepting new patients
Medical College of Wisconsin Affiliated Hospitals Student in an Organized Health Care Education/Training Program PastSince Apr 1, 2020 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1295363828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 5TH ST SE STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724684",
            "telephone_number": "253-848-8797",
            "fax_number": "253-845-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 5TH ST SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724652",
            "telephone_number": "253-848-8797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "999 N 92nd St Ste 730",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532264875",
            "country_code": "US",
            "telephone_number": "414-266-6800",
            "fax_number": "414-337-7068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVERE",
        "first_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "OP61396308",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "76398-21",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.