Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD42711 | WA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD42711 | WA |
NPI | 1174565782 |
---|---|
Provider Name | Douglas S. Musgrave |
First Address | Vancouver, WA 98664-3299 |
Second Address | Vancouver, WA 98664-3299 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2006 |
Last Update Date | 28/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8390494 | (05) | WA |
H56252 | (02) |