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General NPI Number Information
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NPI Number | 1184322471
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Entity Type | Individual
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Provider Name | DANIEL HUMAN DO
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Gender | Male
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Dates
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Enumeration Date | 02/16/2023
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Last Update Date | 12/29/2024
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Provider Practice Location Address
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Address Line | 1322 3RD ST SE STE 240
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City | PUYALLUP
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State | WA
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Zip | 98372-3771
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Country | US
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Telephone | 253-697-1420
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Fax |
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Provider Business Mailing Address
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Address Line | 16609 E DESMET CT APT A101
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-3545
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Country | US
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | FH4337057
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License Number State | WA
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