Provider Demographics
NPI:1407195282
Name:DR. DOUGLAS K. WHITE, PLLC
Entity Type:Organization
Organization Name:DR. DOUGLAS K. WHITE, PLLC
Other - Org Name:OLYMPIC NATUROPATHIC WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:F
Authorized Official - Last Name:TAYLOR-WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:360-794-8183
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-474-9809
Mailing Address - Fax:
Practice Address - Street 1:14841 179TH AVE SE
Practice Address - Street 2:SUITE 230
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1127
Practice Address - Country:US
Practice Address - Phone:360-794-8183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. DOUGLAS K. WHITE, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site