Provider Demographics
NPI:1952493306
Name:CHANDLER, DOUGLAS (MSW)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306B LAKE VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290
Mailing Address - Country:US
Mailing Address - Phone:360-708-9595
Mailing Address - Fax:
Practice Address - Street 1:1511 E BROADWAY
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4556
Practice Address - Country:US
Practice Address - Phone:360-708-9595
Practice Address - Fax:360-568-1654
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000063531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty