Provider Demographics
NPI:1114323318
Name:DANIELS, DOUGLAS LLOYD (EAMP)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:LLOYD
Last Name:DANIELS
Suffix:
Gender:M
Credentials:EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8811 S TACOMA WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-4595
Mailing Address - Country:US
Mailing Address - Phone:253-344-9374
Mailing Address - Fax:253-983-9796
Practice Address - Street 1:8811 S TACOMA WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-4595
Practice Address - Country:US
Practice Address - Phone:253-344-9374
Practice Address - Fax:253-983-9796
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-15
Last Update Date:2014-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00001875171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist