Provider Demographics
NPI:1922146026
Name:WHITE, DOUGLAS K (ND)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:K
Last Name:WHITE
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N LEWIS ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:118 N LEWIS ST
Practice Address - Street 2:SUITE 111
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1516
Practice Address - Country:US
Practice Address - Phone:360-794-8183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA807175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath