Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Bruce R Douglas, PA

Individual provider Physician Assistant · NPI 1417978842

Mr. Bruce R Douglas, PA is a Physician Assistant in Royal City, Washington. Qualified in 1998, 28 years ago. Practices with Kaiser Foundation Health Plan of Washington, a 1,519-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
28
Licensed in
WA
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

103 Camelia St
Royal City, WA 99357
Phone: (509) 663-8711
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 21615 Pacific Hwy S, Des Moines, WA 98198-7703 — (206) 878-7006

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10005338 (WA)

Record details

NPI number1417978842
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedJuly 21, 2006
Last updated in NPPESMarch 30, 2021
Certification dateMarch 30, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Group practice Kaiser Foundation Health Plan Of Washington — 1519 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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