Individual
DR. DONALD GENE WORTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19109 36TH AVE W, SUITE 109, LYNNWOOD, WA 98036-5767
(425) 744-7771
(425) 744-7774
Mailing address
19109 36TH AVE W, SUITE 109, LYNNWOOD, WA 98036-5767
(425) 744-7771
(425) 744-7774
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
MD00020164
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LABOR & INDUSTRY
107361
WA
01
—
REGENCE
WO009
WA
Enumeration date
10/19/2006
Last updated
01/22/2014
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