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Individual

MR. DOUGLAS GANGAT UY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CDP

Contact information

Practice address
1610 C STREET, SUITE 102, VANCOUVER, WA 98663
(360) 787-2125
Mailing address
16420 MCGILLIVRAY BLVD, SUITE 103 PMP 194, VANCOUVER, WA 98683
(360) 787-2125

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
16-R-56
OR
101Y00000X
Counselor
Primary
CP60494259
WA

Other

Enumeration date
07/26/2017
Last updated
07/26/2017
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