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General NPI Number Information
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NPI Number | 1033246673
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Entity Type | Individual
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Provider Name | WILBERT DANIEL JAMES M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 461 G ST
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City | FORKS
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State | WA
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Zip | 98331-9025
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Country | US
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Telephone | 360-374-6224
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Fax | 360-374-6039
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Provider Business Mailing Address
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Address Line | 5318 CHIEF BROWN LN
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City | DARRINGTON
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State | WA
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Zip | 98241-9420
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Country | US
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Telephone | 360-436-0131
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00036777
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License Number State | WA
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