Basic Information
| Provider Information | |||||||||
| NPI: | 1316979644 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIMPSON | ||||||||
| FirstName: | DENNIS | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 825 SE BISHOP BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | PULLMAN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 991635537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093322517 | ||||||||
| FaxNumber: | 5093349247 | ||||||||
| Practice Location | |||||||||
| Address1: | 825 SE BISHOP BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | PULLMAN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 991635537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093322517 | ||||||||
| FaxNumber: | 5093349247 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 07/07/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD00020233 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | M-4552 | ID | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1055201 | 05 | WA | MEDICAID | 003203100 | 05 | ID | MEDICAID |