MEDICARE: DANIEL A WHALEN JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	MD00015815	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861496374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL A WHALEN JR. MD

Provider Business Mailing Address
First Line	:	2819 42ND ST NW
Second Line	:
City	:	GIG HARBOR
State	:	WA
Zip	:	98335-7900
Country	:	US
Telephone Number	:	253-851-6097
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 S UNION AVE
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-1702
Country	:	US
Telephone Number	:	253-459-6611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	07/08/2007

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