Healthcare Provider Details

I. General information

NPI: 1366845257
Provider Name (Legal Business Name): DANIAL KHAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2014
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2608 KWINA RD
BELLINGHAM WA
98226-9291
US

IV. Provider business mailing address

2608 KWINA RD
BELLINGHAM WA
98226-9291
US

V. Phone/Fax

Practice location:
  • Phone: 360-384-0464
  • Fax:
Mailing address:
  • Phone: 360-384-0464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60514687
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN60367859
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: