Provider Demographics
NPI:1912251364
Name:ALLAN KHANH DOAN DPM PLLC
Entity Type:Organization
Organization Name:ALLAN KHANH DOAN DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:KHANH
Authorized Official - Last Name:DOAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:206-722-3745
Mailing Address - Street 1:5200 RAINIER AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-6104
Mailing Address - Country:US
Mailing Address - Phone:206-722-3745
Mailing Address - Fax:206-722-1357
Practice Address - Street 1:5200 RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-6104
Practice Address - Country:US
Practice Address - Phone:206-722-3745
Practice Address - Fax:206-722-1357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO00000689213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5373090001OtherPALMETTO GBA NATIONAL SUPPLIER CLEARINGHOUSE MEDICARE