Provider Demographics
NPI:1437604964
Name:DOUGLAS DUGGAN
Entity Type:Organization
Organization Name:DOUGLAS DUGGAN
Other - Org Name:CLARITY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:DUGGAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:509-836-2818
Mailing Address - Street 1:6022 THYNEWOOD LOOP
Mailing Address - Street 2:
Mailing Address - City:WEST RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99353-6076
Mailing Address - Country:US
Mailing Address - Phone:509-985-6148
Mailing Address - Fax:
Practice Address - Street 1:2695 E LINCOLN AVE
Practice Address - Street 2:STE C
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944-4003
Practice Address - Country:US
Practice Address - Phone:509-836-2818
Practice Address - Fax:509-836-2235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-25
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003836152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2037816Medicaid
WAGAB40094Medicare UPIN