Provider Demographics
NPI:1326336157
Name:SIMPSON, DANIELLE M (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:M
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17446 CROWDER RD SE
Mailing Address - Street 2:
Mailing Address - City:TENINO
Mailing Address - State:WA
Mailing Address - Zip Code:98589-9366
Mailing Address - Country:US
Mailing Address - Phone:360-480-3954
Mailing Address - Fax:
Practice Address - Street 1:100 DENNIS ST SW STE F
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-6523
Practice Address - Country:US
Practice Address - Phone:360-352-6060
Practice Address - Fax:360-357-7339
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60287842152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist