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Individual

DOUGLAS H MAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
13014 120TH AVE NE, KIRKLAND, WA 98034-3015
(425) 821-8004
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
OD00001558
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0039597
LABOR AND INDUSTRIES#
WA
05
2101103
WA
01
MA8570
BLUE SHIELD #
WA
01
US0861769
AETNA SPECIALIST PIN
WA
Enumeration date
02/01/2007
Last updated
06/17/2008
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