Provider Demographics
NPI:1366648297
Name:EGAN, DANIEL NATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:NATHAN
Last Name:EGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 NAGLE PL
Mailing Address - Street 2:APT 104
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2447
Mailing Address - Country:US
Mailing Address - Phone:617-699-2437
Mailing Address - Fax:
Practice Address - Street 1:1221 MADISON ST STE 1020
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1380
Practice Address - Country:US
Practice Address - Phone:206-215-2658
Practice Address - Fax:206-991-2363
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60212119207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1366648297Medicaid
8928154Medicare PIN