Ryan R Douglas, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60989804 Issued in WA

Practice address

2602 St Clair PL
Bellingham, WA 98226-6131

Phone

(360) 201-8218

NPI assigned

Oct 25, 2019

Last updated

Mar 31, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Northwest Youth Services

  • Clinical Social Worker
  • Bellingham, WA
  • NPI 1881281897
  NPD Authorized official

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1316580038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 229076",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982290903",
            "telephone_number": "360-201-8218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 ST CLAIR PL",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982266131",
            "telephone_number": "360-201-8218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "RYAN",
        "middle_name": "R",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-25",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60989804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marlena Dougherty, LMHCA
• Douglas F Wynne MD
• Douglas Madsen, MD, PLLC (Womens Health Northwest)
• James M Douglas Jr., M.D.
• Megan Elizabeth Brown Douglas, LICSW
• Anna Lynne Dowling, M.D.
• Grace Nicole Dowling
• Matthew Dowling, LICSW
• Jeff James Doyle
• Leslie Doyle, MFTA

• Clinical Social Worker in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.