MEDICARE: DR. DANIEL ETHAN KLEIN M.D.

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	2084P0800X	Psychiatry Physician	MD00026098	WA

General Provider Information

NPI Number	:	1952515629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL ETHAN KLEIN M.D.

Provider Business Mailing Address
First Line	:	1425 WESTERN AVE
Second Line	:	SUITE 303
City	:	SEATTLE
State	:	WA
Zip	:	98101-2088
Country	:	US
Telephone Number	:	206-442-9700
Fax Number	:	206-442-9409

Provider Business Practice Location Address
First Line	:	1425 WESTERN AVE
Second Line	:	SUITE 303
City	:	SEATTLE
State	:	WA
Zip	:	98101-2088
Country	:	US
Telephone Number	:	206-442-9700
Fax Number	:	206-442-9409

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/08/2007

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