Provider Demographics
NPI:1780941823
Name:BISHOP, DUANE L
Entity type:Individual
Prefix:MR
First Name:DUANE
Middle Name:L
Last Name:BISHOP
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:PO BOX 1643
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-3643
Mailing Address - Country:US
Mailing Address - Phone:253-514-9722
Mailing Address - Fax:253-444-3552
Practice Address - Street 1:15619 41ST AVE NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-9040
Practice Address - Country:US
Practice Address - Phone:253-514-9722
Practice Address - Fax:253-444-3552
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAREABIEL940L8171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications