Individual
DOUGLAS J. BIRKEBAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
16251 SYLVESTER RD SW, BURIEN, WA 98166-3017
(206) 431-5314
Mailing address
PO BOX 94391, MS/LB 310054, SEATTLE, WA 98124-6691
(888) 579-7777
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10002010
WA
363AM0700X
Medical Physician Assistant
PA10002010
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29624U
REGENCE BLUE SHIELD PIN
WA
05
—
8398158
—
WA
01
—
9622BI
REGENCE BLUE SHIELD PIN
WA
Enumeration date
05/12/2006
Last updated
02/08/2020
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