Healthcare Provider Details

I. General information

NPI: 1770407058
Provider Name (Legal Business Name): DANIEL DENNIS WEBER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 172NS ST NE
ARLINGTON WA
98223
US

IV. Provider business mailing address

4505 103RD PL NE
MARYSVILLE WA
98271-8344
US

V. Phone/Fax

Practice location:
  • Phone: 360-386-4512
  • Fax: 360-659-7399
Mailing address:
  • Phone: 515-450-8476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberOPTI.D0.70004255
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: