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Individual

MS. NANCY E. DOUGLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
21601 76TH AVE W, EDMONDS, WA 98026-7507
(425) 640-4100
Mailing address
1420 E. PINE ST., 301, SEATTLE, WA 98122
(206) 328-6664

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10002305
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5286DO
REGENCE BLUE SHIELD
05
8343147
WA
Enumeration date
11/14/2006
Last updated
06/03/2009
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