Wysham, Douglas G

Wysham, Douglas G is an individual health care provider with primary practice located at 700 Ne 87Th Ave , Vancouver WA 98664-1913. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Wysham, Douglas G can be contacted via phone (360) 882-3662.

Contact Information

Primary practice address
700 Ne 87Th Ave Vancouver WA 98664-1913
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD00029442 Washington
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X MD00029442 Washington

Profile Details

NPI number 1275526360
LBN Legal business name Wysham, Douglas G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated Nov 7th, 2016 - about 8 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 1275526360 NPPES
Washington MEDICAID 8135832

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