Provider Demographics
NPI:1568898344
Name:WHEELER, DOUG JAMES (DPHIL)
Entity Type:Individual
Prefix:DR
First Name:DOUG
Middle Name:JAMES
Last Name:WHEELER
Suffix:
Gender:M
Credentials:DPHIL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18840 NE 159TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-9148
Mailing Address - Country:US
Mailing Address - Phone:206-992-7217
Mailing Address - Fax:
Practice Address - Street 1:18840 NE 159TH ST
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-9148
Practice Address - Country:US
Practice Address - Phone:206-992-7217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005775101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health