Individual provider Active NPI

Douglas R. King

  • Surgery Physician
  • Puyallup, WA
National Provider Identifier
1184643611
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD00023020 Issued in WA
Practice address
1519 3Rd St SE
Ste 230
Puyallup, WA 98372-3742
Phone
(253) 841-9640
Fax
(253) 841-7645
NPI assigned
Jul 18, 2006
Last updated
Dec 30, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD00023020 WA Primary

Addresses

Primary practice location

1519 3Rd St SE
Ste 230
Puyallup, WA 98372-3742

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101110000039 WA Practitioner - General Surgery 2163410002 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Current Accepting new patients
Multicare Health System CurrentSince Jun 17, 2023 Accepting new patients
Proliance Surgeons Inc P S CurrentSince Jan 1, 2015 Accepting new patients
Multicare Health System CurrentSince Jun 17, 2023 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Jan 1, 2015 Accepting new patients
Multicare Health System Current Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

1408 3rd St SE
Ste 150
Puyallup, WA 98372
Phone (253) 841-9640

1519 3rd St SE
Ste 210
Puyallup, WA 98372
Phone (252) 840-4994

1519 3rd St SE
Ste 230
Puyallup, WA 98372
Phone (253) 697-7100

1519 3rd St SE
Ste 240
Puyallup, WA 98372
Phone (253) 840-4994

3801 5th St SE
Ste 110
Puyallup, WA 98374
Phone (253) 845-9585

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: dkingmd6658@direct.multicare.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1184643611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 3RD ST SE",
            "address_2": "STE 230",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723742",
            "telephone_number": "253-841-9640",
            "fax_number": "253-841-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "DOUGLAS",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00023020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.