Individual
DR. WILLIAM K. DOMARAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
505 NE 87TH AVE STE 460, VANCOUVER, WA 98664-1965
(360) 514-7771
(360) 514-7769
Mailing address
814 E 65TH S, IDAHO FALLS, ID 83404-7662
(605) 939-5526
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
02003790A
IN
2084N0400X
Neurology Physician
7330
SD
2084N0400X
Neurology Physician
DO-04320
IA
2084N0400X
Neurology Physician
Primary
OP00001949
WA
2084N0600X
Clinical Neurophysiology Physician
O-1291
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000756863
ANTHEM (REID PHYSICIAN ASSOCIATES, INC.)
—
01
—
000010148189
REGENCE BLUE SHIELD OF ID
ID
05
—
0109759
—
OH
05
—
201057130
—
IN
05
—
806992600
—
ID
01
—
S5247
BLUE CROSS OF IDAHO
ID
Enumeration date
08/05/2006
Last updated
04/19/2026
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