Provider Demographics
NPI:1114250495
Name:TOMCZYK, DANIEL A (PHD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:A
Last Name:TOMCZYK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8275 166TH AVE NE STE 200
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-6629
Mailing Address - Country:US
Mailing Address - Phone:425-869-2644
Mailing Address - Fax:425-867-0930
Practice Address - Street 1:8275 166TH AVE NE STE 200
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-6629
Practice Address - Country:US
Practice Address - Phone:425-869-2644
Practice Address - Fax:425-867-0930
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60620631103TC0700X
TX34307103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2865461-01Medicaid
WA2050347Medicaid
TX2865461-01Medicaid