Provider Demographics
NPI:1366498370
Name:AUSTIN, DANIEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:E
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 W ORCHARD DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1766
Mailing Address - Country:US
Mailing Address - Phone:360-318-8800
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:2075 BARKLEY BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-6614
Practice Address - Country:US
Practice Address - Phone:360-671-3345
Practice Address - Fax:360-650-1354
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00027617207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0128746OtherLABOR & INDUSTRIES (REG)
WA080148649OtherRAILROAD MEDICARE
WA11630OtherREGENCE BLUESHIELD
WA423898014OtherGROUP HEALTH COOPERATIVE
WA8925058OtherLABOR & INDUSTRIES (CV)
WA8127839Medicaid
WA080148649OtherRAILROAD MEDICARE
WA0128746OtherLABOR & INDUSTRIES (REG)