Healthcare Provider Details

I. General information

NPI: 1396818324
Provider Name (Legal Business Name): DANIEL L. NELSON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 06/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3216 NE 45TH PL STE 117
SEATTLE WA
98105-4093
US

IV. Provider business mailing address

3216 NE 45TH PL STE 117
SEATTLE WA
98105-4093
US

V. Phone/Fax

Practice location:
  • Phone: 206-641-7595
  • Fax: 206-641-7596
Mailing address:
  • Phone: 206-641-7595
  • Fax: 206-641-7596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCH00002066
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCH00002066
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberCH00002066
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: