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Individual

MR. DOUGLAS J ICHIKAWA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1609 116TH AVE NE, BELLEVUE, WA 98004-3024
(425) 283-5093
(425) 283-5095
Mailing address
1609 116TH AVE NE, BELLEVUE, WA 98004-3024
(425) 283-5093
(425) 283-5095

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000422
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0231400
L&I
WA
05
1124099601
WA
Enumeration date
01/31/2006
Last updated
12/24/2012
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