Dereck White, LMP
Contractor in Auburn, WA. Individual provider (NPI-1).
NPI number1982970737
StatusActive
Last updated in NPPESMar 27, 2012
Details
- NPI
- 1982970737
- Entity type
- Individual (NPI-1)
- Name
- Dereck White
- Credential
- LMP
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 27, 2012
- Last updated
- Mar 27, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171W00000X | Contractor | MA60272581 | WA | Yes |
Practice location
1221 30th St Se#25
Auburn, WA 98002-8192
Phone 206-909-2693
Mailing address
1221 30th St Se#25
Auburn, WA 98002-8192
Phone 206-909-2693
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