Provider Demographics
NPI:1114084373
Name:DANKE, NANCY A (PAC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:DANKE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:A
Other - Last Name:PTACEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:2930 SQUALICUM PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1854
Mailing Address - Country:US
Mailing Address - Phone:360-733-0430
Mailing Address - Fax:360-733-0438
Practice Address - Street 1:2930 SQUALICUM PKWY
Practice Address - Street 2:SUITE B10
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1854
Practice Address - Country:US
Practice Address - Phone:360-733-0430
Practice Address - Fax:360-733-0438
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10005139363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical