Healthcare Provider Details
I. General information
NPI: 1962708800
Provider Name (Legal Business Name): DANIELLE A PASTER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/09/2011
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5300 TALLMAN AVE NW
SEATTLE WA
98107-3932
US
IV. Provider business mailing address
2016 NE 61ST ST
SEATTLE WA
98115-6921
US
V. Phone/Fax
- Phone: 206-781-6209
- Fax:
- Phone: 608-669-1721
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | ML60106786 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | MEDS7582 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: