Provider Demographics
NPI:1295959583
Name:WILKEY, DOUGLAS FERGUSON (DDS)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:FERGUSON
Last Name:WILKEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:DOUGLAS
Other - Middle Name:FERGUSON
Other - Last Name:WILKEY
Other - Suffix:I
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:623 NW RICHMOND BEACH RD
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-3121
Mailing Address - Country:US
Mailing Address - Phone:206-542-2566
Mailing Address - Fax:206-542-2457
Practice Address - Street 1:623 NW RICHMOND BEACH RD
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98177-3121
Practice Address - Country:US
Practice Address - Phone:206-542-2566
Practice Address - Fax:206-542-2457
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA4311122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist