Individual
DOUGLAS R DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
406 CENTRAL AVE S, QUINCY, WA 98848-1226
(509) 787-0569
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(509) 765-6788
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00003939
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0249871
L&I
WA
05
—
8556276
—
WA
Enumeration date
02/23/2009
Last updated
11/02/2020
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