Park, Douglas J
Park, Douglas J is an individual health care provider with primary practice located at 6926 Ne Fourth Plain Blvd , Vancouver WA 98661. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Park, Douglas J can be contacted via phone (360) 993-3000.Contact Information
Primary practice address
6926 Ne Fourth Plain Blvd
Vancouver WA 98661
Phone: (360) 993-3000
Fax: (360) 993-3047
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PY00001772 | Washington |
Profile Details
| NPI number | 1518033711 |
|---|---|
| LBN Legal business name | Park, Douglas J |
| Credentials | PSYCHOLOGIST PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 28th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518033711 | NPPES |
| Washington | MEDICAID | 8354920 |
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