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NPI Code Detail

MEDICARE: MR. DAVID DANIELS

MEDICARE: MR. DAVID DANIELS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1669347035
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID DANIELS
Provider Business Mailing Address
First Line : PO BOX 6028
Second Line :
City : BEND
State : OR
Zip : 97708-6028
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 65920 OLD BEND REDMOND HWY
Second Line :
City : BEND
State : OR
Zip : 97703-7907
Country : US
Telephone Number : 541-668-6836
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2025
Last Update Date : 10/07/2025

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