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General NPI Number Information
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NPI Number | 1871589135
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Entity Type | Individual
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Provider Name | DANIEL V. PHAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 6508 196TH ST SW
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City | LYNNWOOD
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State | WA
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Zip | 98036-5922
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Country | US
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Telephone | 425-673-2572
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Fax | 425-673-4131
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Provider Business Mailing Address
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Address Line | 6508 196TH ST SW
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City | LYNNWOOD
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State | WA
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Zip | 98036-5922
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Country | US
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Telephone | 425-673-2572
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Fax | 425-673-4131
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD32737
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License Number State | WA
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