Provider Demographics
NPI:1790908937
Name:W DOUGLAS UHL
Entity Type:Organization
Organization Name:W DOUGLAS UHL
Other - Org Name:VERRY-UHL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-373-4999
Mailing Address - Street 1:1470 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8749
Mailing Address - Country:US
Mailing Address - Phone:360-676-4999
Mailing Address - Fax:360-676-5061
Practice Address - Street 1:1470 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8749
Practice Address - Country:US
Practice Address - Phone:360-676-4999
Practice Address - Fax:360-676-5061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001674103TC0700X
WALW000057711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB02196Medicare ID - Type Unspecified