Individual
DOUGLAS Y NIKAITANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001504
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039597
LABOR AND INDUSTRIES#
WA
05
—
2082204
—
WA
01
—
410034402
RAILROAD MEDICARE
WA
01
—
8223NI
BLUE SHIELD #
WA
01
—
US0861770
AETNA SPECIALIST PIN
WA
Enumeration date
02/01/2007
Last updated
06/17/2008
Update your record
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