Individual
DOUGLAS Y NIKAITANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6600
Mailing address
1100 9TH AVE, MS:M4-PA, SEATTLE, WA 98101-2756
(206) 515-5811
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
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