Ichikawa, Douglas J

Ichikawa, Douglas J is an individual health care provider with primary practice located at 1609 116Th Ave Ne , Bellevue WA 98004-3024. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Ichikawa, Douglas J can be contacted via phone (425) 283-5093.

Contact Information

Primary practice address
1609 116Th Ave Ne Bellevue WA 98004-3024
Fax: (425) 283-5095
Website:

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PO00000422 Washington

Profile Details

NPI number 1124099601
LBN Legal business name Ichikawa, Douglas J
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2006
Last updated Dec 24th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124099601 NPPES
Washington Other 0231400 L&I
Washington MEDICAID 1124099601 L&I

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