Provider Demographics
NPI:1427003540
Name:SLOANE, DANIEL EDWIN (DO)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:EDWIN
Last Name:SLOANE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 GOVERNMENT ROAD
Mailing Address - Street 2:PO BOX 1581
Mailing Address - City:MATTAWA
Mailing Address - State:WA
Mailing Address - Zip Code:99349
Mailing Address - Country:US
Mailing Address - Phone:509-932-4499
Mailing Address - Fax:509-932-5363
Practice Address - Street 1:210 GOVERNMENT RD
Practice Address - Street 2:
Practice Address - City:MATTAWA
Practice Address - State:WA
Practice Address - Zip Code:99349-5116
Practice Address - Country:US
Practice Address - Phone:509-932-4499
Practice Address - Fax:509-932-5363
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001392207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA208206OtherLABOR & INDUSTRIES
WA1010030Medicaid
WAF31974Medicare UPIN
WAAB20991Medicare ID - Type Unspecified