| NPI | 1114005584 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2006-11-01 |
| Last Updated | 2020-05-17 |
| Mailing Address | Po Box 23 Olympia, WA 98507-0023 United States Phone: (360) 539-1736 | Fax: (360) 350-5610 📍 View Map |
| Primary Practice Address | 1801 W Bay Dr Nw Ste 104 Olympia, WA 98502-4310 United States Phone: (360) 539-1736 | Fax: (360) 350-5610 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 2084P0800X – Psychiatry & Neurology, Psychiatry | MA | 228522 |
| No | 2084P0800X – Psychiatry & Neurology, Psychiatry | WA | MD60191191 |
| Yes | 2084P0804X – Psychiatry & Neurology, Child & Adolescent Psychiatry | WA | MD60191191 |
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About NPI 1114005584
David Eugene Penner MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1114005584. The primary specialty listed is Psychiatry & Neurology, Child & Adolescent Psychiatry. The provider is located in Olympia, WA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-11-01. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1114005584?
NPI 1114005584 belongs to David Eugene Penner MD, a Psychiatry & Neurology, Child & Adolescent Psychiatry in Olympia, WA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1114005584 active?
The current status of NPI 1114005584 in the NPPES registry is Active. The record was last updated on 2020-05-17.
What specialty is NPI 1114005584?
NPI 1114005584 is classified under the taxonomy Psychiatry & Neurology, Child & Adolescent Psychiatry. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1114005584?
You can verify NPI 1114005584 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1114005584?
The primary practice address on file for NPI 1114005584 is 1801 W Bay Dr Nw Ste 104, Olympia, WA 98502-4310. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1114005584 issued?
NPI 1114005584 was first issued (enumerated) on 2006-11-01. The NPPES record was last updated on 2020-05-17.
Practice Location Map
David Eugene Penner is located at 1801 W Bay Dr Nw Ste 104, Olympia, WA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as David Eugene Penner. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1114005584. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Psychiatry & Neurology, Psychiatry | 228522 | MA |
| Psychiatry & Neurology, Psychiatry | MD60191191 | WA |
| Psychiatry & Neurology, Child & Adolescent Psychiatry | MD60191191 | WA |