Provider Demographics
NPI:1811055890
Name:DOAN, ALLAN KHANH (DPM)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:KHANH
Last Name:DOAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 RAINIER AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-6104
Mailing Address - Country:US
Mailing Address - Phone:206-722-3745
Mailing Address - Fax:206-722-1357
Practice Address - Street 1:5200 RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-6104
Practice Address - Country:US
Practice Address - Phone:206-722-3745
Practice Address - Fax:206-722-1357
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO689213ES0103X
CAE4128213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE4128OtherCALIFORNIA LICENSE
WA1114628Medicaid
WA9052572OtherWASHINGTON DME PROVIDER
WAPO689OtherWASHINGTON LICENSE
WAAB24880Medicare PIN
CAE4128OtherCALIFORNIA LICENSE
WA5373090001Medicare NSC