Active NPI
Donald Fred Devries, M.D.
- Endocrinology, Diabetes & Metabolism Physician
- Puyallup, WA
National Provider Identifier
1790748549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- MD00024699
- Practice address
- 1011 E Main Ave
Suite 302
Puyallup, WA 98372-6775 - Phone
- (253) 841-2471
- Fax
- (253) 841-2472
- NPI assigned
- Apr 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | MD00024699 | WA | Primary |
| Nuclear Imaging & Therapy Physician | 207UN0902X | MD00024699 | WA |
Addresses
Primary practice location
1011 E Main Ave
Suite 302
Puyallup, WA 98372-6775
Mailing address
1011 Main Ave E
Ste 302
Puyallup, WA 98372-6775
Phone (253) 841-2471
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1029032 | Medicaid | WA | |
| 0014041 | Other | WA | LABOR & INDUSTRIES |
| 110187011 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00024699 | WA | MD | Endocrinology, Diabetes & Metabolism Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405987200000",
"number": "1790748549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 MAIN AVE E",
"address_2": "STE 302",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983726775",
"telephone_number": "253-841-2471",
"fax_number": "253-841-2472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 E MAIN AVE",
"address_2": "SUITE 302",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983726775",
"telephone_number": "253-841-2471",
"fax_number": "253-841-2472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVRIES",
"first_name": "DONALD",
"middle_name": "FRED",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-11",
"last_updated": "2014-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "WA",
"license": "MD00024699",
"primary": true
},
{
"code": "207UN0902X",
"taxonomy_group": "",
"desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
"state": "WA",
"license": "MD00024699",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1029032",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "0014041",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110187011",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.