Healthcare Provider Details

I. General information

NPI: 1740015601
Provider Name (Legal Business Name): DANIEL L CAJINA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2024
Last Update Date: 09/02/2024
Certification Date: 09/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 TERRY AVE N
SEATTLE WA
98109-5292
US

IV. Provider business mailing address

111 TERRY AVE N
SEATTLE WA
98109-5292
US

V. Phone/Fax

Practice location:
  • Phone: 201-577-1777
  • Fax:
Mailing address:
  • Phone: 201-577-1777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN61104115
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: