Healthcare Provider Details

I. General information

NPI: 1205883352
Provider Name (Legal Business Name): DANIEL GAVRILA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: M DANIEL GAVRILA MD

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 02/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 116TH AVE NE SUITE #320
BELLEVUE WA
98004-4623
US

IV. Provider business mailing address

1135 116TH AVE NE SUITE #320
BELLEVUE WA
98004-4623
US

V. Phone/Fax

Practice location:
  • Phone: 425-688-8111
  • Fax:
Mailing address:
  • Phone: 425-688-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberMD00037420
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: