Individual
MR. EDOUARD J DURET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
176 1ST AVE N, ILWACO, WA 98624
(360) 642-3747
(360) 642-3361
Mailing address
176 1ST AVE N, PO DRAWER N, ILWACO, WA 98624
(360) 642-3747
(360) 642-3361
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD00036757
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111916
L & I
WA
05
—
8233090
—
WA
01
—
DU7152
BCBS
WA
Enumeration date
09/22/2005
Last updated
07/08/2007
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