Provider Demographics
NPI:1366524589
Name:WHITTEN, DOUGLAS SCOTT (DO)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:SCOTT
Last Name:WHITTEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 SE PARK PLAZA DR
Mailing Address - Street 2:STE 140
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5886
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:203 SE PARK PLAZA DR
Practice Address - Street 2:STE 140
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-5886
Practice Address - Country:US
Practice Address - Phone:360-449-7002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO22080207X00000X
WAOP00001667207X00000X
MI5101011852207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery