Provider Demographics
NPI:1164939120
Name:DANIELS, QUIANA (RN)
Entity Type:Individual
Prefix:
First Name:QUIANA
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:QUIANA
Other - Middle Name:
Other - Last Name:CHILDRESS-WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:PO BOX 2031
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-0031
Mailing Address - Country:US
Mailing Address - Phone:501-920-4653
Mailing Address - Fax:
Practice Address - Street 1:809 LYONS AVE NE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98059-4843
Practice Address - Country:US
Practice Address - Phone:206-310-5101
Practice Address - Fax:206-407-3301
Is Sole Proprietor?:No
Enumeration Date:2017-12-29
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARL046425164W00000X
WALP60672165164W00000X
WARN61423588163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse