Tari Ann Devaney, RDH – Dental Hygienist

Key facts

NPI: 1790182004
Entity type: Individual (NPI type 1)
Primary specialty: Dental Hygienist 124Q00000X
License: DH00004184 (WA)
Practice address: 605 Coolidge Drive
Moses Lake, WA 98837
Phone: (509) 765-0674
NPI assigned: Dec 2, 2014
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
DH00004184	WA	MD	Dental Hygienist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dental Hygienist	124Q00000X	DH00004184	WA	Yes

Addresses

Primary practice location

605 Coolidge Drive
Moses Lake, WA 98837

Mailing address

605 S Coolidge St
Moses Lake, WA 98837-1893
Phone (509) 765-0674

Other identifiers

Identifier	Type	State	Issuer
2040580	Medicaid	WA

Other names

Tari Ryan Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 6, 2016.

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1790182004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371893",
            "telephone_number": "509-765-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 COOLIDGE DRIVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "98837",
            "telephone_number": "509-765-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVANEY",
        "first_name": "TARI",
        "middle_name": "ANN",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-02",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH00004184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2040580",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARI",
            "last_name": "RYAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moses Lake, WA

All providers in Moses Lake, WA · Dental Hygienist in Washington

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.