Healthcare Provider Details

I. General information

NPI: 1265534713
Provider Name (Legal Business Name): RAYMOND NEAL DOGGETT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2006
Last Update Date: 11/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1737 N WENATCHEE AVE STE D
WENATCHEE WA
98801-1189
US

IV. Provider business mailing address

1737 N WENATCHEE AVE STE D
WENATCHEE WA
98801-1189
US

V. Phone/Fax

Practice location:
  • Phone: 509-663-8772
  • Fax: 509-664-1820
Mailing address:
  • Phone: 509-663-8772
  • Fax: 509-664-1820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. RAYMOND N DOGGETT
Title or Position: PROPRIETOR/OWNER
Credential:
Phone: 509-663-8772