Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dean Kirk Douglas, PA-C

Individual provider Surgical Physician Assistant · NPI 1053424333

Dean Kirk Douglas, PA-C is a Physician Assistant in Tacoma, Washington. Qualified in 2006, 20 years ago. Practices with Banner-University Medical Group, a 1,071-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
20
Licensed in
WA
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1112 6th Ave Ste 300
Tacoma, WA 98405-4040
Phone: (253) 272-2224
Fax: (253) 572-4624
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA10005076 (WA)

Record details

NPI number1053424333
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 17, 2006
Last updated in NPPESNovember 10, 2010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Banner-University Medical Group — 1071 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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