Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | MD00022396 | WA |
NPI | 1124082037 |
---|---|
Provider Name | Douglas L Madsen |
First Address | Bellingham, WA 98227-5096 |
Second Address | Bellingham, WA 98226-7123 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 04/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0243325 | L&I AND CRIME VICTIMS (01) | WA |
1124082037 | (05) | WA |
3516MA | REGENCE (01) | WA |
5883376 | AETNA (01) | WA |
A09044 | (02) | WA |