Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD60914768 | WA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | E8431 | TX |
NPI | 1285694711 |
---|---|
Provider Name | Richard W Demmler |
First Address | Puyallup, WA 98373 |
Second Address | Webster, TX 77598-4043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 11/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1293193 | (05) | TX |
B22210 | (02) | TX |