Healthcare Provider Details

I. General information

NPI: 1649255589
Provider Name (Legal Business Name): DOUGLAS DAVID SLATEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8605 SOUTHRIDGE PL
ANACORTES WA
98221-8358
US

IV. Provider business mailing address

8605 SOUTHRIDGE PL
ANACORTES WA
98221-8358
US

V. Phone/Fax

Practice location:
  • Phone: 760-390-8030
  • Fax:
Mailing address:
  • Phone: 760-390-8030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number60458602
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberG59150
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: