Healthcare Provider Details

I. General information

NPI: 1225277072
Provider Name (Legal Business Name): WINSTON DANAI TAVEE M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2009
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 MARTIN LUTHER KING JR WAY
TACOMA WA
98405-4265
US

IV. Provider business mailing address

209 MARTIN LUTHER KING JR WAY
TACOMA WA
98405-4265
US

V. Phone/Fax

Practice location:
  • Phone: 253-596-3300
  • Fax:
Mailing address:
  • Phone: 253-596-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberN2313
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD60782575
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: