Organization
HAZEL DELL SPORTS MEDICINE & REHAB CLINIC PLLC
Active
Other names
Forgey SportsMed & Rehab Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS LEE FORGEY DC (OWNER)
(360) 573-5500
Entity
Organization
Contact information
Practice address
300 GRAND BLVD, STE B200, VANCOUVER, WA 98661-4930
(360) 573-5500
(360) 573-9075
Mailing address
300 GRAND BLVD, STE B200, VANCOUVER, WA 98661-4930
(360) 573-5500
(360) 573-9075
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
WA
207Q00000X
Family Medicine Physician
MD00010276
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0154878
DEPARTMENT OF LABOR & IND
WA
Enumeration date
03/14/2007
Last updated
06/08/2016
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