MEDICARE: DR. DANIEL PETER WALSH DC

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
1	111N00000X	Chiropractor	CH33919	WA

General Provider Information

NPI Number	:	1700960135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL PETER WALSH DC

Provider Business Mailing Address
First Line	:	9633 MARKET PL UNIT 103
Second Line	:
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258-7944
Country	:	US
Telephone Number	:	425-335-0300
Fax Number	:	425-335-0302

Provider Business Practice Location Address
First Line	:	9633 MARKET PL UNIT 103
Second Line	:
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258-7944
Country	:	US
Telephone Number	:	425-335-0300
Fax Number	:	425-335-0302

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	07/12/2022

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