Provider Demographics
NPI:1407822836
Name:DUGAW, JOHN E JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:DUGAW
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14743 CHANNEL DR
Mailing Address - Street 2:
Mailing Address - City:LA CONNER
Mailing Address - State:WA
Mailing Address - Zip Code:98257-4728
Mailing Address - Country:US
Mailing Address - Phone:360-466-5596
Mailing Address - Fax:
Practice Address - Street 1:14743 CHANNEL DR
Practice Address - Street 2:
Practice Address - City:LA CONNER
Practice Address - State:WA
Practice Address - Zip Code:98257-4728
Practice Address - Country:US
Practice Address - Phone:360-466-5596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00015755207QG0300X
WA15755207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine