Provider Demographics
NPI:1144337312
Name:FROESE, DANIEL PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PAUL
Last Name:FROESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1221 MADISON ST STE 1220
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1356
Mailing Address - Country:US
Mailing Address - Phone:206-622-4745
Mailing Address - Fax:206-623-0985
Practice Address - Street 1:1221 MADISON ST STE 1220
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1356
Practice Address - Country:US
Practice Address - Phone:206-622-4745
Practice Address - Fax:206-623-0985
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00024121208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB03730Medicare PIN
WA280001024Medicare PIN
F04548Medicare UPIN