Provider Demographics
NPI:1013050863
Name:DOUGLAS MADSEN, MD, PLLC
Entity Type:Organization
Organization Name:DOUGLAS MADSEN, MD, PLLC
Other - Org Name:WOMENS HEALTH NORTHWEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-738-9570
Mailing Address - Street 1:3015 SQUALICUM PKWY STE 140
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1906
Mailing Address - Country:US
Mailing Address - Phone:360-738-9570
Mailing Address - Fax:360-738-9574
Practice Address - Street 1:3015 SQUALICUM PKWY STE 140
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1906
Practice Address - Country:US
Practice Address - Phone:360-738-9570
Practice Address - Fax:360-738-9574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7128135Medicaid
WA7128135Medicaid
WAAB33516Medicare PIN