Active NPI
Douglas Fredrick Phillip, M.D.
- Preventive Medicine/Occupational Environmental Medicine Physician
- Federal Way, WA
National Provider Identifier
1811954092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine Physician
- License
- MD00023249
- Practice address
- 30042 12TH LN SW
Federal Way, WA 98023-3448 - Phone
- (253) 946-8212
- NPI assigned
- Apr 30, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | MD00023249 | WA | Primary |
Addresses
Primary practice location
30042 12TH LN SW
Federal Way, WA 98023-3448
Mailing address
30042 12TH LN SW
Federal Way, WA 98023-3448
Phone (253) 946-8212
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00023249 | WA | MD | Preventive Medicine/Occupational Environmental Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811954092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30042 12TH LN SW",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980233448",
"telephone_number": "253-946-8212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30042 12TH LN SW",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980233448",
"telephone_number": "253-946-8212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIP",
"first_name": "DOUGLAS",
"middle_name": "FREDRICK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0500X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
"state": "WA",
"license": "MD00023249",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Federal Way, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.