Healthcare Provider Details

I. General information

NPI: 1215290515
Provider Name (Legal Business Name): DANIEL CALEB SHEFFIELD DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1344 WINTERGREEN LANE STE 100
BAINBRIDGE ISLAND WA
98110
US

IV. Provider business mailing address

1344 WINTERGREEN LANE STE 100
BAINBRIDGE ISLAND WA
98110
US

V. Phone/Fax

Practice location:
  • Phone: 206-201-0488
  • Fax: 206-201-0490
Mailing address:
  • Phone: 206-201-0488
  • Fax: 206-201-0490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDO176813
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number14911
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOP60645667
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: