Provider Demographics
NPI:1619040912
Name:DORROUGH, ARLENE E (PA-C)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:E
Last Name:DORROUGH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:E
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4824 S 170TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98188-3256
Mailing Address - Country:US
Mailing Address - Phone:206-817-2349
Mailing Address - Fax:
Practice Address - Street 1:200 ANDOVER PARK E
Practice Address - Street 2:SUITE 8
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2938
Practice Address - Country:US
Practice Address - Phone:206-575-3136
Practice Address - Fax:206-575-7657
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10004920363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical