Healthcare Provider Details
I. General information
NPI: 1255794996
Provider Name (Legal Business Name): DANIELA MEHECH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/31/2016
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 9TH AVE
SEATTLE WA
98101-2756
US
IV. Provider business mailing address
PO BOX 741515
LOS ANGELES CA
90074-1515
US
V. Phone/Fax
- Phone: 206-223-6746
- Fax: 206-625-7278
- Phone: 206-223-6746
- Fax: 206-625-7278
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | MD61523590 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081S0010X |
| Taxonomy | Sports Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | 35.142502 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: