Individual
DOUG NISHIMURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDPT
Contact information
Practice address
22026 20TH AVE SE STE 101, BOTHELL, WA 98021-4449
(425) 672-7293
Mailing address
22026 20TH AVE SE STE 101, BOTHELL, WA 98021-4449
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60586723
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101XA0400X
—
WA
Enumeration date
04/03/2017
Last updated
04/03/2017
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