Provider Demographics
NPI:1184650715
Name:MERRIFIELD, DOUGLAS JAMES (MS, ATC)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:JAMES
Last Name:MERRIFIELD
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Gender:M
Credentials:MS, ATC
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Mailing Address - Street 1:2055 POTTERY AVE
Mailing Address - Street 2:APT. 120
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-2051
Mailing Address - Country:US
Mailing Address - Phone:865-588-8591
Mailing Address - Fax:865-558-4481
Practice Address - Street 1:2055 POTTERY AVE
Practice Address - Street 2:APT. 120
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-2051
Practice Address - Country:US
Practice Address - Phone:865-588-8591
Practice Address - Fax:865-558-4481
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-24
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNAT00000001862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer