Provider Demographics
NPI:1467663484
Name:BALCIRAK, DANEEN MARIE (ND)
Entity Type:Individual
Prefix:DR
First Name:DANEEN
Middle Name:MARIE
Last Name:BALCIRAK
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 361
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:WA
Mailing Address - Zip Code:98862-0361
Mailing Address - Country:US
Mailing Address - Phone:509-996-8107
Mailing Address - Fax:
Practice Address - Street 1:509 LOCUST ST
Practice Address - Street 2:
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841-9383
Practice Address - Country:US
Practice Address - Phone:509-996-8107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000933175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath