Healthcare Provider Details

I. General information

NPI: 1528149812
Provider Name (Legal Business Name): DANIEL D. HARTMAN PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22232 17TH AVE SE STE 302
BOTHELL WA
98021-7425
US

IV. Provider business mailing address

22232 17TH AVE SE STE 302
BOTHELL WA
98021-7425
US

V. Phone/Fax

Practice location:
  • Phone: 425-487-1005
  • Fax: 425-419-0033
Mailing address:
  • Phone: 425-487-1005
  • Fax: 425-419-0033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY00001469
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: