Basic Information
| Provider Information | |||||||||
| NPI: | 1396750725 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DESERTSPRING | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | N. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1303 38TH AVENUE CT NW | ||||||||
| Address2: | |||||||||
| City: | GIG HARBOR | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983357738 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535098740 | ||||||||
| FaxNumber: | 2535090527 | ||||||||
| Practice Location | |||||||||
| Address1: | 1901 S. UNION AVENUE | ||||||||
| Address2: | ALLENMORE HOSPITAL & MEDICAL CENTER | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2534596611 | ||||||||
| FaxNumber: | 2534596244 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2006 | ||||||||
| LastUpdateDate: | 02/03/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 92143 | MT | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | MD 00048897 | WA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 050062716 | 01 | RAILROAD MEDICARE | OTHER | 036097900 | 05 | IL | MEDICAID | 039670 | 01 | HEALTH ALLIANCE | OTHER |