Provider Demographics
NPI:1447226576
Name:DANIELSON, ALAN R (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:R
Last Name:DANIELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:601 W 5TH AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2715
Mailing Address - Country:US
Mailing Address - Phone:509-344-2663
Mailing Address - Fax:509-624-9179
Practice Address - Street 1:601 W 5TH AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2715
Practice Address - Country:US
Practice Address - Phone:509-344-2663
Practice Address - Fax:509-624-9179
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2011-08-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00014143207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010003553OtherBLUE SHIELD OF IDAHO
WA8929869OtherCRIME VICTIMS
WA149073OtherDEPT OF LABOR & INDUSTRIE
ID000010003553OtherREGENCE BLUE SHIELD
379109600OtherOWCP
ID003658600Medicaid
WA1200500Medicaid
WA1350OtherGROUP HEALTH NW
WAKQ522OtherHMO BLUE
WA200040941OtherRR MEDICARE
WAE01159OtherASURIS NW HEALTH
WAKQ522OtherHMO BLUE
WA149073OtherDEPT OF LABOR & INDUSTRIE
WA1200500Medicaid