Provider Demographics
NPI:1679724603
Name:DOUGLAS C. BARTON
Entity Type:Organization
Organization Name:DOUGLAS C. BARTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:425-485-0430
Mailing Address - Street 1:22833 BOTHELL EVERETT HWY
Mailing Address - Street 2:SUITE 154
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-9385
Mailing Address - Country:US
Mailing Address - Phone:425-485-0430
Mailing Address - Fax:425-483-6198
Practice Address - Street 1:22833 BOTHELL EVERETT HWY
Practice Address - Street 2:SUITE 154
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-9385
Practice Address - Country:US
Practice Address - Phone:425-485-0430
Practice Address - Fax:425-483-6198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1413152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0916660001Medicare NSC