MEDICARE: DR. DANIEL JAMES MCNABB D.C.

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	111N00000X	Chiropractor	CH00002824	WA

General Provider Information

NPI Number	:	1972585222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL JAMES MCNABB D.C.

Provider Business Mailing Address
First Line	:	PO BOX 1509
Second Line	:
City	:	BUCKLEY
State	:	WA
Zip	:	98321-1509
Country	:	US
Telephone Number	:	360-829-2125
Fax Number	:	360-829-5313

Provider Business Practice Location Address
First Line	:	135 JEFFERSON AVE
Second Line	:	SUITE L
City	:	BUCKLEY
State	:	WA
Zip	:	98321-1509
Country	:	US
Telephone Number	:	360-829-2125
Fax Number	:	360-829-5313

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

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	09/04/2012

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