Provider Demographics
NPI:1780651083
Name:NORQUIST, DOUGLAS G (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:G
Last Name:NORQUIST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 W 5TH AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2715
Mailing Address - Country:US
Mailing Address - Phone:509-344-2663
Mailing Address - Fax:509-624-9179
Practice Address - Street 1:12410 E SINTO
Practice Address - Street 2:SUITE 201
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-2280
Practice Address - Country:US
Practice Address - Phone:509-928-4334
Practice Address - Fax:509-928-7893
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00016038207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1244201Medicaid
WA482OtherGROUP HEALTH NW
IDK0214OtherBLUE CROSS OF IDAHO
WA55715OtherDEPT OF LABOR & INDUSTRIE
ID000010002341OtherREGENCE BLUE SHIELD OF ID
WA8903162OtherCRIME VICTIMS
WANO4568OtherASURIS NW HEALTH
WA8903162OtherCRIME VICTIMS