Individual
J KIRK DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.P.O.
Contact information
Practice address
10740 MERIDIAN AVE N, STE G2, SEATTLE, WA 98133-9010
(206) 363-7790
(206) 363-7688
Mailing address
10740 MERIDIAN AVE N, STE G2, SEATTLE, WA 98133-9010
(206) 363-7790
(206) 363-7688
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
OI00000062
WA
224P00000X
Prosthetist
Primary
PS00000063
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8418840
—
WA
Enumeration date
06/23/2005
Last updated
04/29/2010
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