MR. BRUCE R DOUGLAS (NPI# 1417978842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417978842 |
| Entity Type | Individual |
| Full Name | MR. BRUCE R DOUGLAS |
| Credential | PA |
| Practice Address |
103 Camelia St. Royal City WA 99357 |
| Mailing Address |
820 N Chelan Ave Wenatchee WA 98801-2028 |
| Practice Telephone | 5096638711 |
| Mailing Telephone | 5096638711 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-10-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 10005338 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811250459 | Bruce Graham Douglas | Nurse Practitioner | 400 El Camino Dr, #210, Cypress Gardens, FL 33884-1697 | 2012-06-19 |
| 1023233558 | Bruce Douglas | Occupational Therapist | 4319 Church Ave, Brooklyn, NY 11203-3101 | 2007-04-17 |
| 1013006444 | Bruce Palmer Douglas | Spec/Tech, Pathology | 100 Albright Way Ste C, Los Gatos, CA 95032-1837 | 2006-10-12 |
| 1134158561 | Bruce C Douglas | Family Medicine | 10803 Se Cherry Blossom Dr, Portland, OR 97216-3107 | 2006-06-30 |
| 1568448553 | Bruce R. Douglas | Radiology | 200 1st St Sw, Rochester, MN 55905-0001 | 2005-12-21 |
| 1891776670 | Bruce Lee Douglas | Dentist | 701 14th St, North Chicago, IL 60064-1409 | 2005-11-09 |
| Street Address |
103 CAMELIA ST. |
| City | ROYAL CITY |
| State | WA |
| Zip Code | 99357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720426596 | Ngoc Huu Quyuh Tran | Physician Assistant | 103 Camelia St Nw, Royal City, WA 99357 | 2013-06-13 |
| 1417297409 | Elaine Prest | Registered Nurse | 230 Wildflower St. Ne, Royal City, WA 99357 | 2013-02-27 |
| 1548507338 | Wenatchee Valley Hospital | Family Medicine | 103 Camelia St. N.w., Royal City, WA 99357 | 2013-01-14 |
| 1629360946 | Robyn J Valdez | Massage Therapist | 124 Fern Street, Royal City, WA 99357 | 2011-05-04 |
| 1740422666 | County of Grant | Ambulance | 336 Camelia St Nw, Royal City, WA 99357 | 2009-03-25 |
| 1174632954 | Laura Broussard | Nurse Practitioner | 103 Camelia St, Royal City, WA 99357 | 2006-08-29 |
| 1811922982 | John P Clark | Physician Assistant | 101 Camelia St Nw, Royal City, WA 99357 | 2006-07-11 |
| 1962586503 | Clinic At Royal City | Non-Pharmacy Dispensing Site | 101 Camelia St Nw, Royal City, WA 99357 | 2006-10-24 |
| 1710075254 | Grant County Fire District No 10 | Ambulance | 336 Camelia St Ne, Royal City, WA 99357-0220 | 2006-10-10 |
| 1538597224 | Louise Ann Andersen | Licensed Practical Nurse | 224 Wildflower Ave Ne, Royal City, WA 99357-0364 | 2013-10-16 |
| Find all providers in zip 99357 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720426596 | Ngoc Huu Quyuh Tran | Physician Assistant | 103 Camelia St Nw, Royal City, WA 99357 | 2013-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790591 | Bailey Mantha-nagrant | Physician Assistant | 7912 170th Ave Ne Unit 301, Redmond, WA 98052-0907 | 2020-11-07 |
| 1518567791 | Addison Christine Richert | Physician Assistant | 121 Kingfisher Pl, Port Hadlock, WA 98339-8733 | 2020-10-28 |
| 1992312177 | Robert Monsees | Physician Assistant | 490 Packwood Ln, Ellensburg, WA 98926-8027 | 2020-09-30 |
| 1649887548 | Jesse E Davis | Physician Assistant | 3512 Serene Way, Lynnwood, WA 98087-5202 | 2020-09-25 |
| 1558977066 | Kimberly Ho | Physician Assistant | 23004 88th Ave W, Edmonds, WA 98026-8616 | 2020-09-20 |
| 1770198954 | Ashish Chaudhary | Physician Assistant | 1215 Dexter Ave N Apt 704, Seattle, WA 98109-3567 | 2020-09-14 |
| 1144835422 | Juleeann Stocking | Physician Assistant | 1517 17th Ave S, Seattle, WA 98144-3522 | 2020-09-13 |
| 1891309555 | Andrew Allyn Bloom | Physician Assistant | 5889 Bow St, Bow, WA 98232-8620 | 2020-09-01 |
| 1558973909 | Margaret Webster | Physician Assistant | 6501 36th Ave Nw, Seattle, WA 98117-6010 | 2020-08-18 |
| 1033720495 | Riley Richardson | Physician Assistant | 1008 E Windemere Ct, Spokane, WA 99223-6228 | 2020-08-11 |
| Find all providers with the same taxonomy | ||||
| City | ROYAL CITY |
| Zip Code | 99357 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.