Healthcare Provider Details

I. General information

NPI: 1578391975
Provider Name (Legal Business Name): JOSEPH DUGAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2024
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 W MAIN ST STE C
MONROE WA
98272-2172
US

IV. Provider business mailing address

12303 HARBOUR POINTE BLVD UNIT X103
MUKILTEO WA
98275-5216
US

V. Phone/Fax

Practice location:
  • Phone: 425-387-1863
  • Fax:
Mailing address:
  • Phone: 425-516-1997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: