Active NPI
Paul Douhan, LICSW, CSOTP
- Clinical Social Worker
- Mount Vernon, WA
National Provider Identifier
1104118611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW 00005540
- Practice address
- 117 N 1St St
Suite 46
Mount Vernon, WA 98273-2859 - Phone
- (360) 336-2626
- Fax
- (360) 630-2034
- NPI assigned
- May 3, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW 00005540 | WA | Primary |
Addresses
Primary practice location
117 N 1St St
Suite 46
Mount Vernon, WA 98273-2859
Mailing address
117 N 1St St
Suite 46
Mount Vernon, WA 98273-2859
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW 00005540 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304380800000",
"number": "1104118611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 N 1ST ST",
"address_2": "SUITE 46",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982732859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 N 1ST ST",
"address_2": "SUITE 46",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982732859",
"telephone_number": "360-336-2626",
"fax_number": "360-630-2034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUHAN",
"first_name": "PAUL",
"credential": "LICSW, CSOTP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-05-03",
"last_updated": "2011-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW 00005540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.