Individual ProviderJames P PurvisDentistDental ProvidersPractice Address800 West Maple Street, Medical Lake, WA 99022-0800(509) 299-3121PECOS EnrollmentBased on the most recent information from CMS, provider James P Purvis does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1609858059Provider TypeIndividualFull NamePurvis, James PTitleDr.CredentialDDSGenderMaleEnumeration Date11/18/2005Last Updated7/9/2007Contact InformationPractice LocationPractice Address800 West Maple Street, Medical Lake, WA 99022-0800Phone(509) 299-3121Fax(509) 299-7015Mailing LocationMailing AddressPO Box 800, 800 West Maple Street, Medical Lake, WA 99022-0800Phone(509) 299-3121Fax(509) 299-7015Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicenseDE00004392WashingtonProvider IdentifiersIDDescriptionIssuerID5357603DescriptionMedicaidIssuerUnlistedWashington