Provider Demographics
NPI:1235664863
Name:DEL MUNDO, DANUEL JOSHUA CATAPANG
Entity Type:Individual
Prefix:
First Name:DANUEL JOSHUA
Middle Name:CATAPANG
Last Name:DEL MUNDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1273 NW 191ST ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-2735
Mailing Address - Country:US
Mailing Address - Phone:206-816-0176
Mailing Address - Fax:
Practice Address - Street 1:1273 NW 191ST ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98177-2735
Practice Address - Country:US
Practice Address - Phone:206-816-0176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVB 60710424390200000X
WAVA60776216183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program