Healthcare Provider Details

I. General information

NPI: 1518034834
Provider Name (Legal Business Name): DANIEL S RASKIND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 112TH AVE NE SUITE A101
BELLEVUE WA
98004-3752
US

IV. Provider business mailing address

1750 112TH AVE NE SUITE A101
BELLEVUE WA
98004-3752
US

V. Phone/Fax

Practice location:
  • Phone: 425-688-5398
  • Fax: 425-688-5756
Mailing address:
  • Phone: 425-688-5398
  • Fax: 425-688-5756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberMD00040552
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: