Individual
DOUGLAS R GWINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 N STANLEY ST, SUITE D, MEDICAL LAKE, WA 99022-8939
(509) 838-2531
Mailing address
PO BOX 3649, SPOKANE, WA 99220-3649
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00030787
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8145989
—
WA
Enumeration date
08/17/2005
Last updated
12/12/2008
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