Provider Demographics
NPI:1356622344
Name:DAMON S PIERCE MD PS
Entity type:Organization
Organization Name:DAMON S PIERCE MD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-532-1360
Mailing Address - Street 1:954 ANDERSON DR
Mailing Address - Street 2:STE 108
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-1001
Mailing Address - Country:US
Mailing Address - Phone:360-532-1360
Mailing Address - Fax:360-532-6878
Practice Address - Street 1:954 ANDERSON DR
Practice Address - Street 2:STE 108
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-1001
Practice Address - Country:US
Practice Address - Phone:360-532-1360
Practice Address - Fax:360-532-6878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-02
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60075926208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty