Healthcare Provider Details

I. General information

NPI: 1598512345
Provider Name (Legal Business Name): DANIELLE FLOWERS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2024
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4205 KITSAP WAY
BREMERTON WA
98312-2447
US

IV. Provider business mailing address

3941 CLEAR ACRE LN APT 236
RENO NV
89512-4213
US

V. Phone/Fax

Practice location:
  • Phone: 360-782-7780
  • Fax:
Mailing address:
  • Phone: 775-527-9231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.PA.70149515
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: