Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | OI00000122 | WA |
N | 222Z00000X | Podiatrist | OI00000122 | WA |
Y | 224P00000X | Prosthetist | PS00000121 | WA |
NPI | 1265752612 |
---|---|
Provider Name | Doug Young |
First Address | Everett, WA 98203-2200 |
Second Address | Sequim, WA 98382-3079 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2010 |
Last Update Date | 08/06/2010 |