MEDICARE: DANIEL E GREENAN DPM

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	213E00000X	Podiatrist	PO00000701	WA
2	213ES0103X	Foot & Ankle Surgery Podiatrist	PO00000701	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00311179	OTHER	WA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	5823620001	OTHER	WA	DME SUPPLIER NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780677047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL E GREENAN DPM

Provider Business Mailing Address
First Line	:	17820 1ST AVE S
Second Line	:	SUITE 101
City	:	BURIEN
State	:	WA
Zip	:	98148-1794
Country	:	US
Telephone Number	:	206-592-5000
Fax Number	:	206-824-9510

Provider Business Practice Location Address
First Line	:	17820 1ST AVE S
Second Line	:	SUITE 101
City	:	BURIEN
State	:	WA
Zip	:	98148-1723
Country	:	US
Telephone Number	:	206-248-3668
Fax Number	:	206-244-2499

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

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	05/13/2014

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Directions to “ DANIEL E GREENAN DPM” Practice Location

Language	Start Address	Practice Location

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