Rutan, Douglas Brent

Rutan, Douglas Brent is an individual health care provider with primary practice located at 100 E 33Rd St Ste 206 , Vancouver WA 98663-2776. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Rutan, Douglas Brent can be contacted via phone (360) 695-1334.

Contact Information

Primary practice address
100 E 33Rd St Ste 206 Vancouver WA 98663-2776
Phone: (360) 695-1334
Fax: (360) 992-1159
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X P0515 Washington

Profile Details

NPI number 1821081613
LBN Legal business name Rutan, Douglas Brent
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 26th, 2005
Last updated Jun 29th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821081613 NPPES
Other 164425100000 PREMARA
Other 480014538 PREMARA
MEDICAID 2047640 PREMARA
Other 050259000 PREMARA

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