Healthcare Provider Details

I. General information

NPI: 1265880272
Provider Name (Legal Business Name): DANIEL JACOB FISCHER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2016
Last Update Date: 05/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US

IV. Provider business mailing address

1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US

V. Phone/Fax

Practice location:
  • Phone: 206-277-1027
  • Fax:
Mailing address:
  • Phone: 206-277-1027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: