Provider Demographics
NPI:1134399637
Name:DENNIS, CURTIS LEE
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:LEE
Last Name:DENNIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 NW FAIRHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-4480
Mailing Address - Country:US
Mailing Address - Phone:360-675-8284
Mailing Address - Fax:
Practice Address - Street 1:555 NW FAIRHAVEN DR
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-4480
Practice Address - Country:US
Practice Address - Phone:360-675-8284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00059655101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor