Individual
DOUGLAS FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.D.O.
Contact information
Practice address
3260 NW MOUNT VINTAGE WAY, SILVERDALE, WA 98383-6000
(360) 698-1685
(360) 698-1763
Mailing address
3260 NW MOUNT VINTAGE WAY, SILVERDALE, WA 98383-6000
(360) 698-1685
(360) 698-1763
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
845
WA
Other
Enumeration date
01/29/2009
Last updated
01/29/2009
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