Provider Demographics
NPI:1720083843
Name:FORGEY, DOUGLAS L (DC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:L
Last Name:FORGEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 GRAND BLVD
Mailing Address - Street 2:STE B200
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-4961
Mailing Address - Country:US
Mailing Address - Phone:360-573-5500
Mailing Address - Fax:360-573-9075
Practice Address - Street 1:300 GRAND BLVD
Practice Address - Street 2:STE B200
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-4961
Practice Address - Country:US
Practice Address - Phone:360-573-5500
Practice Address - Fax:360-573-9075
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001487111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA350055884OtherRAILROAD MEDICARE
WA0154883OtherDEPT OF LABOR & IND
WA8370793Medicaid
WA0154883OtherDEPT OF LABOR & IND
WA350055884OtherRAILROAD MEDICARE