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Individual
DOUGLAS A. DRAKE
Active
Individual
DOUGLAS A. DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
114160
MT
363AS0400X
Surgical Physician Assistant
5432
AZ
363AS0400X
Surgical Physician Assistant
PA60162605
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1086241
NCCPA
—
05
—
835649
—
AZ
Enumeration date
09/29/2009
Last updated
12/29/2023
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