Healthcare Provider Details
I. General information
NPI: 1639474141
Provider Name (Legal Business Name): DOWNEY PLASTIC SURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/13/2011
Last Update Date: 01/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1536 N 115TH ST STE 105
SEATTLE WA
98133-8400
US
IV. Provider business mailing address
1536 N 115TH ST STE 105
SEATTLE WA
98133-8400
US
V. Phone/Fax
- Phone: 206-368-1160
- Fax: 206-368-1159
- Phone: 206-368-1160
- Fax: 206-368-1159
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | 603052906 |
| License Number State | WA |
VIII. Authorized Official
Name: DR.
DANIEL
L
DOWNEY
Title or Position: OWNER
Credential: MD
Phone: 206-368-1160