DR. DAVID EUGENE PENNER (NPI# 1114005584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114005584 |
| Entity Type | Individual |
| Full Name | DR. DAVID EUGENE PENNER |
| Credential | MD |
| Practice Address |
1801 W Bay Dr Nw Ste 104 Olympia WA 98502-4310 |
| Mailing Address |
Po Box 23 Olympia WA 98507-0023 |
| Practice Telephone | 3605391736 |
| Practice Fax Number | 3603505610 |
| Mailing Telephone | 3605391736 |
| Mailing Fax Number | 3603505610 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-05-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD60191191 | WA | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
228522 | MA | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
MD60191191 | WA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144546748 | David L Penner | Surgery | 2315 Stockton Blvd, Suite Op 512 Pavilion, Sacramento, CA 95817-2201 | 2010-04-08 |
| 1518081462 | David R Penner | Psychologist | 21907 64th Ave W, Suite 220, Mountlake Terrace, WA 98043-6200 | 2007-03-18 |
| Street Address |
1801 W BAY DR NW STE 104 |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98502-4310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801409172 | Fanny Cordero | Interpreter | 1415 4th Ave W, Olympia, WA 98502 | 2020-08-26 |
| 1235762832 | Accessible Living Physical Therapy | Clinic/Center | 3524 7th Ave Se, Olympia, WA 98502 | 2020-02-21 |
| 1548807738 | Kaiser Foundation Health Plan of Washington | Pharmacy | 1200 Cooper Point Road Sw, Suite 100, Olympia, WA 98502 | 2019-12-06 |
| 1851946388 | Katherine Ann Vitela | Registered Nurse | 4909 Green Wood Dr Sw, Olympia, WA 98502 | 2019-08-01 |
| 1538632658 | Carmen Rae Breding | Massage Therapist | 2627 Capital Mall Dr Se, Olympia, WA 98502 | 2019-01-11 |
| 1285129155 | Fook Yee Cheung | Genetic Counselor, MS | 2010 Caton Way Sw Ste 102, Olympia, WA 98502 | 2018-06-24 |
| 1942724158 | William Coburn | Specialist/Technologist | 703 Lilly Road Ne, Suite 104, Olympia, WA 98502 | 2017-07-29 |
| 1225567415 | Thierry Buckner | Counselor | 2400 Bristol Court Sw, Olympia, WA 98502 | 2017-06-09 |
| 1619406048 | Trenton Reid | Massage Therapist | 2103 Harrison Ave Nw #2642, Olympia, WA 98502 | 2017-06-08 |
| 1962807305 | Richa Mehta | Dentist | 1530 Black Lake Boulevard, Suite A103, Olympia, WA 98502 | 2014-10-28 |
| Find all providers in zip 98502 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700839891 | John Robert Holttum | Psychiatry & Neurology | 324 W Bay Dr Nw, Suite 214a, Olympia, WA 98502-4926 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225674963 | Multicare Health System | Psychiatry & Neurology | 4700 Point Fosdick Dr Ste 319, Gig Harbor, WA 98335-1731 | 2019-11-18 |
| 1235792326 | Wellpsyche Seattle PC | Psychiatry & Neurology | 801 2nd Ave Ste 800, Seattle, WA 98104-1573 | 2019-04-15 |
| 1043624240 | Lucas Mcintyre | Psychiatry & Neurology | 316 S I St Fl 1, Tacoma, WA 98405-4212 | 2014-06-16 |
| 1184043010 | Shad Syed Ali | Psychiatry & Neurology | 2511 M Ave Ste G, Anacortes, WA 98221-3897 | 2014-04-08 |
| 1710223896 | Jack Raskin | Psychiatry & Neurology | 2624 161st Ave Se, Bellevue, WA 98008-5424 | 2012-12-18 |
| 1801140876 | Deborah L. Hickey, D.o.ps | Psychiatry & Neurology | 6512-20th St Ct W #c, Firerest, WA 98466-6212 | 2012-10-30 |
| 1073884102 | Larry W. Einspahr, M.d., P.s. | Psychiatry & Neurology | 5400 Carillon Pt Bldg 5000, 4th Floor, Kirkland, WA 98033-7357 | 2012-01-20 |
| 1982922233 | Brian N Gipstein | Psychiatry & Neurology | 4407 S Madelia St, Spokane, WA 99223-6429 | 2010-05-12 |
| 1063667087 | Robert S Fleming II | Psychiatry & Neurology | 16921 14th Ave Nw, Shoreline, WA 98177-3840 | 2008-11-18 |
| 1306000898 | Amy Lazar | Psychiatry & Neurology | 11820 Northup Way Ste E200, Bellevue, WA 98005-1966 | 2008-07-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.